Document Detail


Can chest ultrasonography replace standard chest radiography for evaluation of acute dyspnea in the ED?
MedLine Citation:
PMID:  20947649     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We examined the concordance between chest ultrasonography and chest radiography in patients with dyspnea, using chest CT scanning as the gold standard in case of mismatch between the two modalities.
METHODS: A prospective, blinded, observational study was conducted in the ED of a university-affiliated teaching hospital. All consecutive patients presenting for dyspnea during a single emergency physician shift were enrolled independently from the underlying disease. Only patients with trauma were excluded.
RESULTS: Both ultrasonography and radiography were performed in 404 patients; CT scanning was performed in 118 patients. Ultrasound interpretation was completed during the scan, whereas the average time between radiograph request and its final interpretation was 1 h and 35 min. Ultrasonography and radiography exhibited high concordance in most pulmonary diseases, especially in pulmonary edema (κ = 95%). For lung abnormalities such as free pleural effusion, loculated pleural effusion, pneumothorax, and lung consolidation, the concordance was similar for both left- and right-side lungs (all P not significant). When ultrasound scans and radiographs gave discordant results, CT scans confirmed the ultrasound findings in 63% of patients (P < .0001). Particularly, ultrasonography exhibited greater sensitivity than radiography in patients with free pleural effusion (P < .0001).
CONCLUSIONS: When performed by one highly trained physician, our study demonstrated high concordance between ultrasonography and radiography. When ultrasound scans and radiographs disagreed, ultrasonography proved to be more accurate in distinguishing free pleural effusion. Thus, considering the short time needed to have a final ultrasound report, this technique could become the routine imaging modality for patients with dyspnea presenting to the ED.
Authors:
Maurizio Zanobetti; Claudio Poggioni; Riccardo Pini
Related Documents :
23105739 - Study of genetic, metabolic and inflammatory risk factors in patients of acute ischemic...
4006649 - Symptomatic sarcoidosis of the stomach.
891049 - Unusual presentation of tuberculosis in chronic hemodialysis patients.
2316559 - The use of low dose methotrexate in refractory sarcoidosis.
17045789 - Clinical characteristics and outcomes of empyema thoracis in 117 patients: a comparativ...
2014359 - Airflow limitation in sarcoidosis--a study of pulmonary function in 107 patients with n...
19171829 - Tp53 codon 72 polymorphism is associated with age at onset of glioblastoma.
2040479 - Gall stone disease in african patients with sickle cell anaemia: a preliminary report f...
15547809 - Intercellular adhesion molecule-1 expression in nasal polyps treated with corticosteroid.
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-10-14
Journal Detail:
Title:  Chest     Volume:  139     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-04     Completed Date:  2011-07-18     Revised Date:  2011-12-08    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1140-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Critical Care Medicine and Surgery, University of Florence, Italy. zanomau@libero.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aged, 80 and over
Dyspnea / radiography*,  ultrasonography*
Emergencies
Emergency Service, Hospital
Female
Humans
Male
Middle Aged
Prospective Studies
Radiography, Thoracic
Young Adult
Comments/Corrections
Comment In:
Chest. 2011 Nov;140(5):1386-7; author reply 1387   [PMID:  22045887 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The effect of supplemental oxygen on hypercapnia in subjects with obesity-associated hypoventilation...
Next Document:  Minimally Important Change in a Parent-Proxy Quality-of-Life Questionnaire for Pediatric Chronic Cou...