A comparative study between bedside pleuropulmonary ultrasonography and chest X-ray in patients with dyspnea
10.3760/cma.j.issn.1004-4477.2017.02.006
- VernacularTitle:床旁超声与胸部X线对呼吸困难患者胸膜肺病变诊断的比较研究
- Author:
Hong LI
;
Yidan LI
;
Weiwei ZHU
;
Qizhe CAI
;
Lanlan SUN
;
Lingyun KONG
;
Xiaoguang YE
;
Xiuzhang LYU
- Keywords:
Ultrasonography;
Dyspnea;
Lung diseases;
Pleural diseases;
Chest X-ray;
CT
- From:
Chinese Journal of Ultrasonography
2017;26(2):116-120
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the ability of high resolution pleuropulmonary ultrasonography and bedside chest X-ray in identifying different pathologic abnormalities in patients with dyspnea,using thoracic computed tomography (CT) as a gold standard.Methods Bedside pleuropulmonary ultrasonography was performed in 350 dyspneic patients in the emergency department and ICU,111 patients were enrolled in the study with pleuropulmonary ultrasonography,chest X-ray and chest CT examination performed within 24 hours.Pathologic entities were evaluated:pleural effusion,consolidation,atelectasis,pneumothorax,pulmonary interstitial fibrosis,and pulmonary edema.The sensitivity,specificity,negative and positive prediction value of pleuropulmonary ultrasonography and chest X-ray were compared with the corresponding CT scan results.Results Pleuropulmonary ultrasonography was highly concordant with chest X-ray.Overall ultrasonography exhibited higher sensitivity than chest X-ray and CT for pleural effusion.For atelectasis and pulmonary edema,the sensitivity of ultrasonography was up to 100%.In the diagnosis of pulmonary interstitial fibrosis,the sensitivity of pleuropulmonary ultrasonography was higher than that of chest X-ray,but the specificity was slightly lower.The sensitivity of pleuropulmonary ultrasonography was slightly higher than that of chest X-ray in pneumothorax,and the specificity was coincident with chest X-ray.Although the sensitivity of ultrasonography was slightly lower for consolidation,it was still higher than chest X-ray.The ability of chest X-ray for differentiating pleural effusion from atelectasis or consolidation was worse than that of ultrasonography.Conclusions Our study demonstrates a high concordance between ultrasonography with radiography.The diagnostic performance of bedside pleuropulmonary ultrasonography is better than that of chest X-ray.