Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 4;12(1):36.
doi: 10.1186/s13089-020-00183-6.

Value of point-of-care ultrasonography compared with computed tomography scan in detecting potential life-threatening conditions in blunt chest trauma patients

Amirhosein Jahanshir  1 , Shida Mohajer Moghari  2 , Ayat Ahmadi  3 , Pejman Z Moghadam  4 , Maryam Bahreini  5
Affiliations

Value of point-of-care ultrasonography compared with computed tomography scan in detecting potential life-threatening conditions in blunt chest trauma patients

Amirhosein Jahanshir et al. Ultrasound J. .

Abstract

Background: Ultrasonography is a suitable modality that can potentially improve patient care, saving time and lives.

Purpose: This article has evaluated the caveats and pitfalls of point-of-care ultrasonography in the diagnosis of pneumothorax, hemothorax and contusion.

Materials and methods: This prospective study was performed in 157 patients with blunt chest trauma in 3 university hospitals. Ultrasonography was performed by 2 board-certified emergency medicine specialists and an emergency medicine resident PGY-3 after passing the training process successfully.

Results: The false-negative cases were not significantly correlated with accompanying traumatic injuries. Lung ultrasonography accompanied by chest physical examination show accuracy 91.8. Point-of-care ultrasonography (PoCUS) showed sensitivity 75.0%, specificity 100%, positive-predictive value (PPV) of 100% and a negative-predictive value (NPV) of 94.9% for the diagnosis of pneumothorax. For hemothorax, bedside PoCUS had a sensitivity of 45.4%, specificity of 100%, PPV of 100% and NPV of 91.8%. PoCUS was assessed 58.1% sensitive and 100% specific for detecting lung contusion with positive-predictive value (PPV) of 100% and a negative-predictive value (NPV) of 86.3%. Performing US resulted in no false-positive cases.

Conclusions: Point-of-care ultrasonography was highly sensitive to detect pneumothorax and can be beneficial for the disposition of stable patients and to detect PTX in unstable patients before transferring to the operating room. It is also moderately appropriate for the diagnosis of hemothorax and lung contusion compared to the gold standard, CT scan. It is essential to consider the false-negative and false-positive instances of lung ultrasound in various situations to enhance management and disposition of blunt thoracic injuries.

Keywords: Chest injury; Computed tomography; Emergency; Hemothorax; Lung injury; Pneumothorax; Predictive value of tests; Ultrasonography.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The Venn diagram of the positive samples for pneumothorax, hemothorax and lung contusion detected by ultrasonography
See this image and copyright information in PMC

References

    1. Kline JP, Dionisio D, Sullivan K, Early T, Wolf J, Kline D. Detection of pneumothorax with ultrasound. AANA J. 2013;81:265–271. - PubMed
    1. Broderick SR. Hemothorax: etiology, diagnosis, and management. Thorac Surg Clin. 2013;23(89–96):6–7. - PubMed
    1. Ludwig C, Koryllos A. Management of chest trauma. J Thorac Dis. 2017;9:S172. doi: 10.21037/jtd.2017.03.52. - DOI - PMC - PubMed
    1. Helmy S, Beshay B, Abdel Hady M, Mansour A. Role of chest ultrasonography in the diagnosis of lung contusion. Egypt J Chest Diseases and Tuberc. 2015;64:469–475. doi: 10.1016/j.ejcdt.2014.11.021. - DOI
    1. Ianniello S, Piccolo CL, Trinci M, Ajmone Cat CA, Miele V. Extended-FAST plus MDCT in pneumothorax diagnosis of major trauma: time to revisit ATLS imaging approach? J Ultrasound. 2019;22:461–469. doi: 10.1007/s40477-019-00410-4. - DOI - PMC - PubMed

LinkOut - more resources