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  3. 卷 7 编号 1 (2019): Continuous volume
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卷 7 编号 1 (2019)

一月 2019

Comparing Sensitivity of Ultrasonography and Plain Chest Radiography in Detection of Pneumonia; a Diagnostic Value Study

  • Ebrahim Karimi

学术急诊医学档案, 卷 7 编号 1 (2019), 1 一月 2019 , 第 e8 页
https://doi.org/10.22037/aaem.v7i1.287 已出版: 2019-01-22

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摘要

Introduction: Rapid detection of pneumonia and early initiation of antibiotic therapy are associated with better prognosis in patients. The present study was designed aiming to evaluate the sensitivity of chest ultrasonography performed by emergency medicine specialists in detection of pneumonia and comparing it with plain radiography.

Methods: In the present diagnostic accuracy study, patients presenting to the emergency department with clinical symptoms of lung infection underwent plain radiography, ultrasonography, and computed tomography (CT) scan of chest and the screening performance characteristics of plain radiography and ultrasonography were compared considering CT scan findings as the gold standard.

Results: 280 patients with the mean age of 56.47 ± 19.79 (10 – 92) years were studied (57.1% male). The results of chest CT scan were indicative of infection symptoms being present and confirmed pneumonia diagnosis for all the patients. Out of the 280 cases of pneumonia confirmed via chest CT scan, 17 (6.1%) cases were not detected via ultrasonography and 48 (17.1%) cases were missed by chest radiography (false negative cases). No false positive case was reported by ultrasonography or chest x-ray. Since all of the CT scans were positive, no comment can be made regarding the specificity of the evaluated tests, but sensitivity of ultrasonography and plain radiography were 93.92 (90.28 – 96.31) and 82.85 (77.81 – 86.97), respectively (p = 0.583).

Conclusion: Based on the findings of the present study, although the sensitivity of ultrasonography in detection of pneumonia was significantly higher than chest x-ray, overall the screening performance characteristics of the 2 tests were not significantly different. Therefore, considering characteristics such as safety, low cost, being portable, and being available, ultrasonography seems to be a reasonable tool for screening and diagnosis of patients with pneumonia.

关键词:
  • Diagnostic imaging
  • ultrasonography
  • sensitivity and specificity
  • radiography
  • thoracic
  • tomography
  • x-ray computed
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Karimi E. Comparing Sensitivity of Ultrasonography and Plain Chest Radiography in Detection of Pneumonia; a Diagnostic Value Study. Arch Acad Emerg Med [网际网络]. 2019年1月22日 [见引于 2026年7月7日];7(1):e8. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/287
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参考

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Gaieski DF, Mikkelsen ME, Band RA, Pines JM, Massone R, Furia FF, et al. Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Critical care medicine. 2010;38(4):1045-53.

Kumar A, Zarychanski R, Light B, Parrillo J, Maki D, Simon D, et al. Early combination antibiotic therapy yields improved survival compared with monotherapy in septic shock: a propensity-matched analysis. Critical care medicine. 2010;38(9):1773-85.

Rosh AJ, Newman DH. Evidence-based emergency medicine/rational clinical examination abstract. Diagnosing pneumonia by medical history and physical examination. Ann Emerg Med. 2005;46(5):465-7.

Bourcier J-E, Paquet J, Seinger M, Gallard E, Redonnet J-P, Cheddadi F, et al. Performance comparison of lung ultrasound and chest x-ray for the diagnosis of pneumonia in the ED. The American journal of emergency medicine. 2014;32(2):115-8.

Self WH, Courtney DM, McNaughton CD, Wunderink RG, Kline JA. High discordance of chest x-ray and computed tomography for detection of pulmonary opacities in ED patients: implications for diagnosing pneumonia. The American journal of emergency medicine. 2013;31(2):401-5.

Taghizadieh A, Ala A, Rahmani F, Nadi A. Diagnostic Accuracy of Chest x-Ray and Ultrasonography in Detection of Community Acquired Pneumonia; a Brief Report. 2014. 2014;3(3):3.

Cortellaro F, Colombo S, Coen D, Duca PG. Lung ultrasound is an accurate diagnostic tool for the diagnosis of pneumonia in the emergency department. Emerg Med J. 2012;29(1):19-23.

Brenner DJ, Hall EJ. Computed tomography--an increasing source of radiation exposure. The New England journal of medicine. 2007;357(22):2277-84.

Esayag Y, Nikitin I, Bar-Ziv J, Cytter R, Hadas-Halpern I, Zalut T, et al. Diagnostic value of chest radiographs in bedridden patients suspected of having pneumonia. The American journal of medicine. 2010;123(1):88.e1-5.

Yousefifard M, Baikpour M, Ghelichkhani P, Asady H, Shahsavari Nia K, Moghadas Jafari A, et al. Screening Performance Characteristic of Ultrasonography and Radiography in Detection of Pleural Effusion; a Meta-Analysis. 2016. 2016;4(1):10.

Chavez MA, Shams N, Ellington LE, Naithani N, Gilman RH, Steinhoff MC, et al. Lung ultrasound for the diagnosis of pneumonia in adults: a systematic review and meta-analysis. Respiratory research. 2014;15(1):50.

Caiulo VA, Gargani L, Caiulo S, Fisicaro A, Moramarco F, Latini G, et al. Lung ultrasound characteristics of communityâ€acquired pneumonia in hospitalized children. Pediatric pulmonology. 2013;48(3):280-7.

Karimi E, Aminianfar M, Zarafshani K, Safaie A. The Accuracy of Emergency Physicians in Ultrasonographic Screening of Acute Appendicitis; a Cross Sectional Study. 2016. 2016;5(1).

Reissig A, Copetti R, Mathis G, Mempel C, Schuler A, Zechner P, et al. Lung ultrasound in the diagnosis and follow-up of community-acquired pneumonia: a prospective, multicenter, diagnostic accuracy study. Chest. 2012;142(4):965-72.

Bedetti G, Gargani L, Corbisiero A, Frassi F, Poggianti E, Mottola G. Evaluation of ultrasound lung comets by hand-held echocardiography. Cardiovascular ultrasound. 2006;4:34.

Shah S, Noble VE, Umulisa I, Dushimiyimana JM, Bukhman G, Mukherjee J, et al. Development of an ultrasound training curriculum in a limited resource international setting: successes and challenges of ultrasound training in rural Rwanda. International journal of emergency medicine. 2008;1(3):193-6.

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