Which ultrasound transducer type is best for diagnosing pneumothorax?

IF 3.6 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
R Ketelaars, E Gülpinar, T Roes, M Kuut, G J van Geffen
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引用次数: 8

Abstract

Background: An accurate physical examination is essential in the care of critically ill and injured patients. However, to diagnose or exclude a pneumothorax, chest auscultation is unreliable compared to lung ultrasonography. In the dynamic prehospital environment, it is desirable to have the best possible ultrasound transducer readily available. The objective is to assess the difference between a linear-array, curved-array, and phased-array ultrasound transducer in the assessment for pneumothorax and to determine which is best.

Methods: In this double-blinded, cross-sectional, observational study, 15 observers, experienced in lung ultrasonography, each assessed 66 blinded ultrasound video clips of either normal ventilation or pneumothorax that were recorded with three types of ultrasound transducers. The clips were recorded in 11 adult patients that underwent thoracoscopic lung surgery immediately before and after the surgeon opened the thorax. The diagnostic accuracy of the three transducers, elapsed time until a diagnosis was made, and the perceived image quality was recorded.

Results: In total, 15 observers assessed 990 ultrasound video clips. The overall sensitivity and specificity were 98.2% and 97.2%, relatively. No significant difference was found in the diagnostic performance between transducers. A diagnosis was made slightly faster in the linear-array transducer clips, compared to the phased-array transducer (p = .031). For the linear-, curved-, and phased-array transducer, the image quality was rated at a median (interquartile range [IQR]) of 4 (IQR 3-4), 3 (IQR 2-4), and 2 (IQR 1-2), relatively. Between the transducers, the difference in image quality was significant (p < .0001).

Conclusions: There was no difference in diagnostic performance of the three transducers. Based on image quality, the linear-array transducer might be preferred for (prehospital) lung ultrasonography for the diagnosis of pneumothorax.

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哪种超声换能器最适合诊断气胸?
背景:准确的体格检查对危重病人和受伤病人的护理至关重要。然而,要诊断或排除气胸,胸部听诊与肺部超声检查相比是不可靠的。在动态院前环境中,最好的超声换能器随时可用是可取的。目的是评估线性阵列、曲线阵列和相控阵超声换能器在气胸评估中的区别,并确定哪一种是最好的。方法:在这项双盲、横断面、观察性研究中,15名有肺超声检查经验的观察者,每人评估66个正常通气或气胸的盲法超声视频片段,这些视频片段由三种类型的超声换能器记录。这些片段被记录在11名接受胸腔镜肺手术的成年患者身上,这些患者在外科医生开胸之前和之后立即接受了胸腔镜肺手术。三个换能器的诊断准确性,经过的时间,直到诊断,并感知图像质量被记录。结果:共15名观察员评估了990个超声视频片段。总体敏感性和特异性分别为98.2%和97.2%。不同传感器的诊断性能无显著差异。与相控阵换能器相比,线性阵列换能器夹的诊断速度略快(p = 0.031)。对于线性、弯曲和相控阵换能器,图像质量的相对中位数(四分位数范围[IQR])为4 (IQR 3-4)、3 (IQR 2-4)和2 (IQR 1-2)。结论:三种传感器的诊断性能无显著差异。基于图像质量,线阵换能器可能优先用于(院前)肺部超声诊断气胸。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Critical Ultrasound Journal
Critical Ultrasound Journal RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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审稿时长
13 weeks
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