scholarly journals Agreement between chest ultrasonography and chest X-ray in patients who have undergone thoracic surgery: preliminary results

2019 ◽  
Vol 14 ◽  
Author(s):  
Andrea Smargiassi ◽  
Riccardo Inchingolo ◽  
Marco Chiappetta ◽  
Leonardo Petracca Ciavarella ◽  
Stefania Lopatriello ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Rater Agreement ◽  
Pleural Effusions ◽  
Cohen’S Kappa ◽  
Chest Ultrasonography ◽  
X Ray ◽  
Cohen's Kappa ◽  
Diaphragm Position ◽  
Chest X Ray ◽  
Ionizing Radiations

Background: Chest Ultrasonography (chest US) has shown good sensibility in detecting pneumothorax, pleural effusions and peripheral consolidations and it can be performed bedside. Objectives: The aim of the study was to analyze agreement between chest US and chest X-ray in patients who have undergone thoracic surgery and discuss cases of discordance. Methods: Patients undergoing thoracic surgery were retrospectively selected. Patients underwent routinely Chest X-ray (CXR) during the first 48 h after surgery. Chest US have been routinely performed in all selected patients in the same date of CXR. Chest US operators were blind to both reports and images of CXR. Ultrasonographic findings regarding pneumothorax (PNX), subcutaneous emphysema (SCE), lung consolidations (LC), pleural effusions (PE) and hemi-diaphragm position were collected and compared to corresponding CXR findings. Inter-rater agreement between two techniques was determined by Cohen’s kappa-coefficient. Results: Twenty-four patients were selected. Inter-rater agreement showed a moderate magnitude for PNX (Cohen’s Kappa 0.5), a slight/fair magnitude for SCE (Cohen’s Kappa 0.21), a fair magnitude for PE (Cohen’s Kappa 0.39), no agreement for LCs (Cohen’s Kappa 0.06), high levels of agreement for position of hemi-diaphragm (Cohen’s Kappa 0.7). Conclusion: Analysis of agreement between chest X-ray and chest US showed that ultrasonography is able to detect important findings for surgeons. Limitations and advantages have been found for both chest X-ray and chest US. Knowing the limits of each one is important to really justify and optimize the use of ionizing radiations.

scholarly journals Agreement between chest ultrasonography and chest X-ray in patients who have undergone thoracic surgery: preliminary results

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Andrea Smargiassi ◽  
Riccardo Inchingolo ◽  
Marco Chiappetta ◽  
Leonardo Petracca Ciavarella ◽  
Stefania Lopatriello ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Chest Ultrasonography ◽  
X Ray ◽  
Preliminary Results ◽  
Chest X Ray

Agreement between chest ultrasonography and chest X-ray in patients who have undergone thoracic surgery

2018 ◽  
Author(s):  
Andrea Smargiassi ◽  
Riccardo Inchingolo ◽  
Marco Chiappetta ◽  
Leonardo Petracca Ciavarella ◽  
Stefania Lopatriello ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Chest Ultrasonography ◽  
X Ray ◽  
Chest X Ray

scholarly journals A case of pleuroperitoneal communication in which establishing a laparoscopic pneumoperitoneum was useful for the detection of a fistula

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takehiko Manabe ◽  
Kenji Ono ◽  
Soichi Oka ◽  
Yuichiro Kawamura ◽  
Toshihiro Osaki
Keyword(s):  
Thoracic Surgery ◽  
Surgical Repair ◽  
Abdominal Cavity ◽  
Case Presentation ◽  
X Ray ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Pleuroperitoneal Communication ◽  
Small Pore ◽  
Chest X Ray

Abstract Background Pleuroperitoneal communication (PPC) is rarely observed, accounting for 1.6% of all patients who undergo continuous ambulatory peritoneal dialysis (CAPD). Although there have been several reports concerning the management of this condition, we have encountered several cases in which control failed. We herein report a valuable case of PPC in which laparoscopic pneumoperitoneum with video-assisted thoracic surgery (VATS) was useful for supporting the diagnosis and treatment. Case presentation The patient was a 58-year-old woman with chronic renal failure due to chronic renal inflammation who was referred to a nephrologist in our hospital to undergo an operation for the induction of CAPD. Post-operatively, she had respiratory failure, and chest X-ray and computed tomography (CT) showed right-sided hydrothorax that decreased when the injection of peritoneal dialysate was interrupted. Therefore, PPC was suspected, and she was referred to our department for surgical repair. We planned surgical treatment via video-assisted thoracic surgery. During the surgery, we failed to detect any lesions with thoracoscopy alone; we therefore added a laparoscopic port at her right-sided abdomen near the navel and infused CO2 gas into the abdominal cavity. On thoracoscopy, bubbles were observed emanating from a small pore at the central tendon of the diaphragm, which was considered to be the lesion responsible for the PPC. We closed it by suturing directly. Conclusions VATS with laparoscopic pneumoperitoneum should be considered as an effective method for inspecting tiny pores of the diaphragm, especially when the lesions responsible for PPC are difficult to detect.

scholarly journals Classification of Shoulder X-ray Images with Deep Learning Ensemble Models

2021 ◽  
Vol 11 (6) ◽  
pp. 2723
Author(s):  
Fatih Uysal ◽  
Fırat Hardalaç ◽  
Ozan Peker ◽  
Tolga Tolunay ◽  
Nil Tokgöz
Keyword(s):  
Deep Learning ◽  
Performance Test ◽  
The Body ◽  
Test Accuracy ◽  
Cohen’S Kappa ◽  
X Ray ◽  
Cohen's Kappa ◽  
Auc Value ◽  
Magnetic Resonance Imaging Mri ◽  
Fully Connected

Fractures occur in the shoulder area, which has a wider range of motion than other joints in the body, for various reasons. To diagnose these fractures, data gathered from X-radiation (X-ray), magnetic resonance imaging (MRI), or computed tomography (CT) are used. This study aims to help physicians by classifying shoulder images taken from X-ray devices as fracture/non-fracture with artificial intelligence. For this purpose, the performances of 26 deep learning-based pre-trained models in the detection of shoulder fractures were evaluated on the musculoskeletal radiographs (MURA) dataset, and two ensemble learning models (EL1 and EL2) were developed. The pre-trained models used are ResNet, ResNeXt, DenseNet, VGG, Inception, MobileNet, and their spinal fully connected (Spinal FC) versions. In the EL1 and EL2 models developed using pre-trained models with the best performance, test accuracy was 0.8455, 0.8472, Cohen’s kappa was 0.6907, 0.6942 and the area that was related with fracture class under the receiver operating characteristic (ROC) curve (AUC) was 0.8862, 0.8695. As a result of 28 different classifications in total, the highest test accuracy and Cohen’s kappa values were obtained in the EL2 model, and the highest AUC value was obtained in the EL1 model.

scholarly journals Ventilator-associated pneumonia in neonates: the role of point of care lung ultrasound

2020 ◽  
Vol 180 (1) ◽  
pp. 137-146
Author(s):  
Nora Tusor ◽  
Angela De Cunto ◽  
Yousef Basma ◽  
John L. Klein ◽  
Virginie Meau-Petit
Keyword(s):  
Lung Disease ◽  
Chronic Lung Disease ◽  
Lung Ultrasound ◽  
Clinical Laboratory ◽  
Control Group ◽  
Ventilator Associated Pneumonia ◽  
Lung Pathology ◽  
Rater Agreement ◽  
X Ray ◽  
Chest X Ray

AbstractNo consensus exists regarding the definition of ventilator-associated pneumonia (VAP) in neonates and reliability of chest X-ray (CXR) is low. Lung ultrasound (LU) is a potential alternative diagnostic tool. The aim was to define characteristics of VAP in our patient population and propose a multiparameter score, incorporating LU, for VAP diagnosis. Between March 25, 2018, and May 25, 2019, infants with VAP were identified. Clinical, laboratory and microbiology data were collected. CXRs and LU scans were reviewed. A multiparameter VAP score, including LU, was calculated on Day 1 and Day 3 for infants with VAP and for a control group and compared with CXR. VAP incidence was 10.47 episodes/1000 ventilator days. LU and CXR were available for 31 episodes in 21 infants with VAP, and for six episodes in five patients without VAP. On Day 1, a VAP score of > 4, and on Day 3 a score of > 5 showed sensitivity of 0.94, and area under the curve of 0.91 and 0.97, respectively. AUC for clinical information only was 0.88 and for clinical and CXR 0.85.Conclusion: The multiparameter VAP score including LU could be useful in diagnosing VAP in neonates with underlying lung pathology. What is Known:• Ventilator associated pneumonia (VAP) is common in infants on the neonatal unit and is associated with increased use of antibiotics, prolonged ventilation and higher incidence of chronic lung disease.• Commonly used definitions of VAP are difficult to apply in neonates and interpretation of chest X-ray is challenging with poor inter-rater agreement in patients with underlying chronic lung disease. What is New:• The multiparameter VAP score combining clinical, microbiology and lung ultrasound (LU) data is predictive for VAP diagnosis in preterm infants with chronic lung disease.• LU findings of VAP in neonates showed high inter-rater agreement and included consolidated lung areas, dynamic bronchograms and pleural effusion.

scholarly journals Sensitivity of lung ultrasound for the detection of pneumothorax one day after pulmonary resection—a prospective observational study

2020 ◽  
Author(s):  
Thomas Galetin ◽  
Mark Schieren ◽  
Benjamin Marks ◽  
Jerome Defosse ◽  
Erich Stoelben
Keyword(s):  
Observational Study ◽  
Thoracic Surgery ◽  
Test Performance ◽  
Prospective Observational Study ◽  
Lung Ultrasound ◽  
Lung Resection ◽  
X Ray ◽  
Therapeutic Decisions ◽  
Chest X Ray ◽  
Diagnostic Test Performance

Summary Background Chest X‑ray (CXR) after thoracic surgery contributes to patient discomfort and costs and is of limited therapeutic value. Lung ultrasound (LU) for pneumothorax may be an alternative to CXR, but diagnostic accuracy data are heterogeneous and biased by insufficient sonographic technique and patient selection. Reported sensitivities range from 0.21 to 1.0. We evaluated the sensitivity of LU on the first day after thoracic surgery under routine conditions. Methods We performed a prospective observational study (trial-ID DRKS00014557). Consecutive patients undergoing lung resection received standardized LU in addition to routine CXR on the first postoperative day. Ultrasound examiner and radiologist were blinded to corresponding X‑ray and ultrasound findings. CXR was used as reference to determine diagnostic test performance of ultrasound. The conformity of sonography- and routine-based therapeutic decisions was evaluated. Results A total of 68 patients were examined. The mean duration of ultrasound was 145 ± 64 s. CXR identified 23 patients with pneumothorax with a mean apex-to-cupola size of 1.5 ± 1.0 cm. Ultrasound detected 18 patients with pneumothorax. The computed sensitivity of LU was 0.48 (95% confidence interval [0.36; 0.60]). Specificity was between 0.81 and 1.0, the negative predictive value 0.76 [0.66; 0.86]. The sensitivity of CXR was 0.56 [0.44; 0.68]. Air leakage via chest tube correlated weakly with CXR (spearman’s rho = 0.26) and moderately with LU (rho = 0.43). The conformity between sonographically based recommendations and the actual therapy based on routine diagnostics was 96%. Conclusions Sensitivity of ultrasound for pneumothorax detection nearly reached CXR and resulted in equally safe patient management. Our data can serve as a pilot study for upcoming larger-scaled controlled trials.

scholarly journals Characteristics of Chest X-Ray in Patients with Cancer at the Dharmais Cancer Hospital Emergency Room during the COVID-19 Pandemic

2021 ◽  
Vol 15 (4) ◽  
pp. 195
Author(s):  
Bima Taruna Sakti ◽  
Rosalina Rosalina ◽  
Jaka Pradipta
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Pleural Effusion ◽  
Pleural Effusions ◽  
Hospital Emergency ◽  
X Ray ◽  
Patients With Cancer ◽  
Cancer Hospital ◽  
Hospital Emergency Room ◽  
Chest X Ray

Background: Conventional chest X-ray (chest X-ray) in Dharmais Cancer Hospital emergency room (ER) is still the primary modality to diagnose patients with cancer with dyspnoea complaints. Chest X-ray was also carried out to screen inpatients at the Dharmais Cancer Hospital ER at the beginning of the COVID-19 pandemic in Indonesia. It was essential because patients in the Dharmais Cancer Hospital ER were patients with cancer, with low immunity and a high risk of being exposed to various infections. Thus, the purpose of this study was to determine the characteristics of chest X-rays in patients with cancer at the Dharmais Cancer Hospital ER during the COVID-19 pandemic in February-May 2020. Methods: This was a descriptive study. The population involved was all patients at the Dharmais Cancer Hospital ER who received chest X-ray support, with the inclusion criteria for diagnosing lung cancer, breast cancer, cervical cancer, colorectal cancer, and blood cancer (Leukemia) from February to May 2020. Data analysis employed univariate analysis by utilizing tables and graphs in presenting the data.Results: 289 samples met the research criteria. The highest visits were patients with breast cancer (41.2%). The most common thoracic images were pleural effusion (34.3%), followed by bronchopneumonia (31.1%), normal lung (16.6%), lung mass (7.6%), pneumonia (5.2%), and others (5.2%), consisting of atelectasis, bronchitis, fibrosis/chronic pulmonary process, pulmonary emphysema, cardiomegaly, and specific process. Besides, the chest x-ray bronchopneumonia was 31.1% (90 samples), accompanied by pleural effusion of 44.4%. From the chest X-ray, pleural effusions were 34.3% (99 samples), with lung cancer being the most common with pleural effusions (48.4%).Conclusions: More than 80% of chest x-ray performed in the ER are abnormal. Also, breast cancer is the highest in the Dharmais Cancer Hospital ER cases, with the highest chest x-ray of pleural effusion.

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