Background and Aims While chest X-ray (CXR) has been a conventional tool in intensive care units (ICUs) to identify lung pathologies, computed tomography (CT) scan remains the gold standard. Use of lung ultrasound (LU...Background and Aims While chest X-ray (CXR) has been a conventional tool in intensive care units (ICUs) to identify lung pathologies, computed tomography (CT) scan remains the gold standard. Use of lung ultrasound (LUS) in resource-rich ICUs is still under investigation. The present study compares the utility of LUS to that of CXR in identifying pulmonary edema and pleural effusion in ICU patients. In addition, consolidation and pneumothorax were analyzed as secondary outcome measures. Material and Methods This is a prospective, single centric, observational study. Patients admitted in ICU were examined for lung pathologies, using LUS by a trained intensivist;and CXR done within 4 hours of each other. The final diagnosis was ascertained by an independent senior radiologist, based on the complete medical chart including clinical findings and the results of thoracic CT, if available. The results were compared and analyzed. Results Sensitivity, specificity and diagnostic accuracy of LUS was 95%, 94.4%, 94.67% for pleural effusion;and 98.33%, 97.78%, 98.00% for pulmonary edema respectively. Corresponding values with CXR were 48.33%, 76.67%, 65.33% for pleural effusion;and 36.67%, 82.22% and 64.00% for pulmonary edema respectively. Sensitivity, specificity and diagnostic accuracy of LUS was 91.30%, 96.85%, 96.00% for consolidation;and 100.00%, 79.02%, 80.00% for pneumothorax respectively. Corresponding values with CXR were 60.87%, 81.10%, 78.00% for consolidation;and 71.3%, 97.20%, 96.00% for pneumothorax respectively. Conclusion LUS has better diagnostic accuracy in diagnosis of pleural effusion and pulmonary edema when compared with CXR and is thus recommended as an effective alternative for diagnosis of these conditions in acute care settings. Our study recommends that a thoracic CT scan can be avoided in most of such cases.展开更多
The study was conducted to determine the role of radiological investigation in assessing the severity of COVID-19 pneumonia with the help of chest X-ray (CXR), high resolution computed tomography (HRCT), and ultrasoun...The study was conducted to determine the role of radiological investigation in assessing the severity of COVID-19 pneumonia with the help of chest X-ray (CXR), high resolution computed tomography (HRCT), and ultrasound. This was a retrospective study conducted on 105 COVID-19 patients with symptoms of fever, cough, dyspnea, loss of sense of smell and taste, body ache. Diagnostic tests PCR were positive for COVID-19 included from Medicare Cardiac and General Hospital and Jinnah Medical College Hospital Korangi (JMCH) from April to November 2020. Written informed consent was taken from all participants. This study was approved by ethical review committee, Jinnah Medical & Dental College. Real time-PCR (RT-PCR) was done for the confirmation. Radiological imaging including Chest X-ray, HRCT chest, and ultrasound was done to study the severity of symptoms. Sixty-five patients had mild to moderate symptoms with oxygen saturation between 96% - 98% and 30 patients with severe pneumonia had between saturation 50% - 55%. Patients with mild symptoms were followed up by chest X-ray showing mostly normal chest X-rays but single or patches of ground glass opacities (HRCT). HRCT of 10 patients with low oxygen saturation 50% were already done showing bilateral peripheral patchy consolidation predominantly involving mid and lower lobes. 3 patients presented with patchy lung opacities and ultrasound showing similar findings with pleural effusion and ascites. Radiological imaging, specially CT-Scan was highly significant for diagnosing COVID-19 and severity of infection even in patients with negative PCR. Chest X-ray and ultrasound were also found to be a very useful tool.展开更多
文摘Background and Aims While chest X-ray (CXR) has been a conventional tool in intensive care units (ICUs) to identify lung pathologies, computed tomography (CT) scan remains the gold standard. Use of lung ultrasound (LUS) in resource-rich ICUs is still under investigation. The present study compares the utility of LUS to that of CXR in identifying pulmonary edema and pleural effusion in ICU patients. In addition, consolidation and pneumothorax were analyzed as secondary outcome measures. Material and Methods This is a prospective, single centric, observational study. Patients admitted in ICU were examined for lung pathologies, using LUS by a trained intensivist;and CXR done within 4 hours of each other. The final diagnosis was ascertained by an independent senior radiologist, based on the complete medical chart including clinical findings and the results of thoracic CT, if available. The results were compared and analyzed. Results Sensitivity, specificity and diagnostic accuracy of LUS was 95%, 94.4%, 94.67% for pleural effusion;and 98.33%, 97.78%, 98.00% for pulmonary edema respectively. Corresponding values with CXR were 48.33%, 76.67%, 65.33% for pleural effusion;and 36.67%, 82.22% and 64.00% for pulmonary edema respectively. Sensitivity, specificity and diagnostic accuracy of LUS was 91.30%, 96.85%, 96.00% for consolidation;and 100.00%, 79.02%, 80.00% for pneumothorax respectively. Corresponding values with CXR were 60.87%, 81.10%, 78.00% for consolidation;and 71.3%, 97.20%, 96.00% for pneumothorax respectively. Conclusion LUS has better diagnostic accuracy in diagnosis of pleural effusion and pulmonary edema when compared with CXR and is thus recommended as an effective alternative for diagnosis of these conditions in acute care settings. Our study recommends that a thoracic CT scan can be avoided in most of such cases.
文摘The study was conducted to determine the role of radiological investigation in assessing the severity of COVID-19 pneumonia with the help of chest X-ray (CXR), high resolution computed tomography (HRCT), and ultrasound. This was a retrospective study conducted on 105 COVID-19 patients with symptoms of fever, cough, dyspnea, loss of sense of smell and taste, body ache. Diagnostic tests PCR were positive for COVID-19 included from Medicare Cardiac and General Hospital and Jinnah Medical College Hospital Korangi (JMCH) from April to November 2020. Written informed consent was taken from all participants. This study was approved by ethical review committee, Jinnah Medical & Dental College. Real time-PCR (RT-PCR) was done for the confirmation. Radiological imaging including Chest X-ray, HRCT chest, and ultrasound was done to study the severity of symptoms. Sixty-five patients had mild to moderate symptoms with oxygen saturation between 96% - 98% and 30 patients with severe pneumonia had between saturation 50% - 55%. Patients with mild symptoms were followed up by chest X-ray showing mostly normal chest X-rays but single or patches of ground glass opacities (HRCT). HRCT of 10 patients with low oxygen saturation 50% were already done showing bilateral peripheral patchy consolidation predominantly involving mid and lower lobes. 3 patients presented with patchy lung opacities and ultrasound showing similar findings with pleural effusion and ascites. Radiological imaging, specially CT-Scan was highly significant for diagnosing COVID-19 and severity of infection even in patients with negative PCR. Chest X-ray and ultrasound were also found to be a very useful tool.
