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Thoracic Imaging |
1 From the Department of Radiology (K.R.R., D.L., K.E.F., J.R.M., S.N.) and Section of Trauma Services (A.W.K.), Vancouver Hospital and Health Sciences Centre, 899 W 12th Ave, Vancouver, British Columbia, Canada V5Z 1M9. From the 2000 RSNA scientific assembly. Received June 25, 2001; revision requested July 27; final revision received March 20, 2002; accepted April 11. Address correspondence to S.N. (e-mail: snicolao@vanhosp.bc.ca).
PURPOSE: To prospectively compare the accuracy of ultrasonography (US) with that of supine chest radiography in the detection of traumatic pneumothoraces, with computed tomography (CT) as the reference standard.
MATERIALS AND METHODS: Thoracic US, supine chest radiography, and CT were performed to assess for pneumothorax in 27 patients who sustained blunt thoracic trauma. US and radiographic findings were compared with CT findings, the reference standard, for pneumothorax detection. For the purpose of this study, the sonographers were blinded to the radiographic and CT findings.
RESULTS: Eleven of 27 patients had pneumothorax at CT. All 11 of these pneumothoraces were detected at US, and four were seen at supine chest radiography. In the one false-positive US case, the patient was shown to have substantial bullous emphysema at CT. Sensitivity and negative predictive value of US were 100% (11 of 11 and 15 of 15 patients, respectively), specificity was 94% (15 of 16 patients), and positive predictive value was 92% (11 of 12 patients). Chest radiography had 36% (four of 11 patients) sensitivity, 100% (16 of 16 patients) specificity, a 100% (four of four patients) positive predictive value, and a 70% (16 of 23 patients) negative predictive value.
CONCLUSION: In this study, US was more sensitive than supine chest radiography and as sensitive as CT in the detection of traumatic pneumothoraces.
Supplemental material: radiology.rsnajnls.org/cgi/content/full/2251011102/DC1
© RSNA, 2002
Index terms: Pneumothorax, 60.732 • Thorax, CT, 60.12111, 60.12112, 60.12115 • Thorax, radiography, 60.11 • Thorax, US, 60.12981, 60.12989
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