Evaluation of diagnostic accuracy of bed-side ultrasound accompanied by chest X-ray in comparison with CT Scan in patient with blunt and penetrated chest trauma

Abstract

Considering that in recent years the need for available methods to detect trauma damage has increased and the high cost of imaging with CT scans has been discussed with the dangers of radiation and studies have suggested the use of chest ultrasound instead of radiation imaging in the diagnosis of pneumothorax, rib fractures, etc., so we decided to design a study in which the diagnostic accuracy of ultrasound on the patient's bedside Chest graphics compared to CT scans in patients with penetrating and non -penetrating chest trauma.. Methods: This cross -sectional and forward -looking study was conducted on 140 patients with penetrating or non -chest trauma. After informed consent of patients based on the results of clinical examinations and CXR, they had a chest CT scan indicator, before the CT scanning chest CT scans, the point-off-care ultrasound for them Was performed. All patients were then evaluated by a chest CT scan. CXR and CT scans were reported by a radiologist at Tabriz University of Medical Sciences who are not aware of the ultrasound results. Then the results of bedside ultrasound with CXR were compared with the results of CT scan. Results: The majority of patients in both male groups had a mean age of about 32 to 35 years. The hemodynamic status of the majority of patients in both groups was stable. Complications of trauma in patients were pneumothorax, hemothorax, emphysema, lung contusion, fracture and pericardial tamponade effusion. Chest ultrasound has better sensitivity (76.19%), specificity (93.87%), accuracy (88.57%), positive predictive value (84.21%) and negative predictive value (90.19%) than Graphics with sensitivity (61.90%), specificity (95.91%), accuracy (85.71%), positive predictive value (86.66%) and negative predictive value (85.45%) in the diagnosis of pneumothorax follow blunt trauma. In penetrating traumas, chest ultrasound has a higher value than chest x-ray too. Chest X-ray has a better diagnostic value than ultrasound in the diagnosis of fracture following blunt trauma. Chest ultrasound had high sensitivity, accuracy, and negative predictive value in the diagnosis of hemothorax in patients with blunt trauma. In patients with penetrating chest X-ray trauma, it had almost the same diagnostic value in diagnosing hemothorax comparison ultrasound with a sensitivity of (82.35%) and an accuracy of (95.71%). Chest X-ray with sensitivity (64.28%), specificity (91.10%), accuracy (85.71%), positive predictive value (64.28%) and negative predictive value (91.10%) is better than ultrasound in diagnosing lung contusion following blunt trauma But in penetrating traumas, chest ultrasound has a higher sensitivity (77.27%) and accuracy (88.75%) than a chest x-ray with sensitivity (65.00%). Chest X-ray along with chest ultrasound has a high and acceptable diagnostic value in the diagnosis of pulmonary emphysema in both groups of patients with blunt and penetrating trauma. Ultrasound is a good alternative in the diagnosis of pericardial effusion and tamponade for CT scan.