Performance of thoracic ultrasonography compared with chest radiography for the detection of rib fractures using computed tomography as a reference standard.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-11-01 Epub Date: 2024-03-19 DOI:10.1007/s00256-024-04658-8

Evangelia E Vassalou, Iraklis Perysinakis, Michail E Klontzas, Eelco de Bree, Apostolos H Karantanas

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引用次数: 0

Abstract

Objective: Although there is growing evidence that ultrasonography is superior to X-ray for rib fractures' detection, X-ray is still indicated as the most appropriate method. This has partially been attributed to a lack of studies using an appropriate reference modality. We aimed to compare the diagnostic accuracy of ultrasonography and X-ray in the detection of rib fractures, considering CT as the reference standard.

Materials and methods: Within a 2.5-year period, all consecutive patients with clinically suspected rib fracture(s) following blunt chest trauma and available posteroanterior/anteroposterior X-ray and thoracic CT were prospectively studied and planned to undergo thoracic ultrasonography, by a single operator. All imaging examinations were evaluated for cortical rib fracture(s), and their location was recorded. The cartilaginous rib portions were not assessed. CTs and X-rays were evaluated retrospectively. Concomitant thoracic/extra-thoracic injuries were assessed on CT. Comparisons were performed with the Mann-Whitney U test and Fisher's exact test.

Results: Fifty-nine patients (32 males, 27 females; mean age, 53.1 ± 16.6 years) were included. CT, ultrasonography, and X-ray (40 posteroanterior/19 anteroposterior views) diagnosed 136/122/42 rib fractures in 56/54/27 patients, respectively. Ultrasonography and X-ray had sensitivity of 100%/40% and specificity of 89.7%/30.9% for rib fractures' detection. Ultrasound accuracy was 94.9% compared to 35.4% for X-rays (P < .001) in detecting individual rib fractures. Most fractures involved the 4th-9th ribs. Upper rib fractures were most commonly overlooked on ultrasonography. Thoracic cage/spine fractures and haemothorax represented the most common concomitant injuries.

Conclusion: Ultrasonography appeared to be superior to X-ray for the detection of rib fractures with regard to a reference CT.

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以计算机断层扫描为参考标准，比较胸部超声波与胸部放射摄影在检测肋骨骨折方面的性能。

目的：尽管越来越多的证据表明，超声波检查在肋骨骨折的检测中优于 X 光检查，但 X 光检查仍被认为是最合适的方法。部分原因是缺乏使用适当参考模式的研究。我们将 CT 作为参考标准，旨在比较超声波和 X 光在检测肋骨骨折方面的诊断准确性：在 2.5 年的时间里，我们对所有在胸部钝性创伤后临床疑似肋骨骨折的连续患者进行了前瞻性研究，并计划由一名操作员进行胸部超声波检查。所有造影检查都对肋骨皮质骨折进行了评估，并记录了骨折位置。软骨肋骨部分未作评估。对 CT 和 X 光片进行回顾性评估。同时进行的胸廓/胸廓外损伤通过 CT 进行评估。比较采用 Mann-Whitney U 检验和 Fisher's 精确检验：共纳入 59 名患者（32 名男性，27 名女性；平均年龄为 53.1 ± 16.6 岁）。CT、超声波和 X 光（40 个后正位切面/19 个前正位切面）分别诊断出 56/54/27 例患者的 136/122/42 根肋骨骨折。超声波和 X 光检查对肋骨骨折检测的敏感性分别为 100%/40%，特异性分别为 89.7%/30.9%。超声检查的准确率为 94.9%，而 X 光检查的准确率为 35.4%（P 结论：超声检查似乎比 X 光检查更准确：与参考 CT 相比，超声波检查在检测肋骨骨折方面似乎优于 X 光检查。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.