Can lung ultrasound replace the chest X-ray? A prospective multicenter study
10.3760/cma.j.issn.1673-4912.2023.11.006
- VernacularTitle:肺部超声是否能取代胸部X线检查？一项前瞻性多中心研究
- Author:
Yangming QU
1
;
Shuyu SI
;
Huiqing SUN
;
Pingyang CHEN
;
Qianshen ZHANG
;
Li MA
;
Zhaoqing YIN
;
Min XIAO
;
Jimei WANG
;
Xirong GAO
;
Ling LIU
;
Jinxing FENG
;
Yanping ZHU
;
Di JIN
;
Jing ZHANG
;
K. Shoo LEE
;
Hui WU
Author Information
1. 吉林大学第一医院新生儿科，长春 130012
- Keywords:
Lung ultrasound;
Chest X-ray;
Diagnosis
- From:
Chinese Pediatric Emergency Medicine
2023;30(11):834-839
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the accuracy of lung ultrasound and chest X-ray in the diagnosis of neonatal pulmonary disease.Methods:We prospectively collected newborns that needed chest X-ray examination to diagnose pulmonary disease from twelve neonatal intensive care units across the country between June 2019 and April 2020.Each newborn was examined by lung ultrasound within two hours after chest X-ray examination.All chest X-ray and lung ultrasound images were independently read by a radiologist and a sonographer.When there was a disagreement, a panel of two experienced physicians made a final diagnosis based on the clinical history, chest X-ray and lung ultrasound images.Results:A total of 1 100 newborns were enrolled in our study.The diagnostic agreement between chest X-ray and lung ultrasound(Cohen′s kappa coefficient=0.347) was fair.Lung ultrasound(area under the curve=0.778; 95% CI 0.753-0.803) performed significantly better than chest X-ray(area under the curve=0.513; 95% CI 0.483-0.543) in the diagnosis of transient tachypnea of the newborn( P<0.001). The accuracy of lung ultrasound in diagnosing neonatal respiratory distress syndrome, meconium aspiration syndrome, pneumonia and neonatal pulmonary atelectasis was similar to that of chest X-ray. Conclusion:Lung ultrasound, as a low-cost, simple and radiation-free auxiliary examination method, has a diagnostic accuracy close to or even better than that of chest X-ray, which may replace chest X-ray in the diagnosis of some neonatal lung diseases.It should be noted that both chest X-ray and lung ultrasound can only be used as auxiliary means for the diagnosis of lung diseases, and it is necessary to combine imaging with the clinical history and presentation.
