Comparison of ultrasonography and computed tomography in the determination of traumatic thoracic injuries

In this study, the accuracy of bedside thoracic ultrasonography (TUSG) performed by emergency physicians with patients in the supine position was compared with that of thoracic computed tomography (TCT) for the determination of thoracic injuries due to trauma. Patients who suffered the multiple trau...

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Bibliographic Details
Published in:The American journal of emergency medicine 2019-05, Vol.37 (5), p.864-868
Main Authors: Kozaci, Nalan, Avcı, Mustafa, Ararat, Ertan, Pinarbasili, Tansu, Ozkaya, Muharrem, Etli, Ibrahim, Donertas, Eda, Karakoyun, Omer F.
Format: Article
Language:English
Subjects:
Abdomen
Adolescent
Adult
Computed tomography
Computerized tomography
Contusions
Effusion
Emergency management
Emergency medical care
Emergency medical services
Emergency preparedness
Emergency Service, Hospital
Emphysema
Female
Focused Assessment with Sonography for Trauma - methods
Fractures
Hemothorax
Humans
Injuries
Injury Severity Score
Male
Medical imaging
Medical personnel
Middle Aged
Multiple Trauma - diagnostic imaging
Patients
Pneumothorax
Prospective Studies
Sensitivity and Specificity
Sternum
Supine position
Tamponade
Thoracic Injuries - diagnostic imaging
Thoracic trauma
Thorax
Tomography, X-Ray Computed - methods
Trauma
Ultrasonic imaging
Ultrasonography
Ultrasound
Young Adult
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Summary:In this study, the accuracy of bedside thoracic ultrasonography (TUSG) performed by emergency physicians with patients in the supine position was compared with that of thoracic computed tomography (TCT) for the determination of thoracic injuries due to trauma. Patients who suffered the multiple traumas, whose thoracic trauma was identified on physical examination or TCT imaging were included in the study. TUSG was performed following a physical examination by the emergency physician who managed the trauma patient. Subcutaneous emphysema, pneumothorax, pulmonary contusions (PCs), hemothorax, pericardial effusion and tamponade, sternal and clavicular fractures and rib fractures were identified by TUSG. TCT imaging was performed after the ultrasonography examination was completed. Eighty-one patients were included in the study. TCT scans showed subcutaneous emphysema in 16 (19.8%) patients, pneumothorax in 21 (25.9%), PCs in 27 (33.3%), hemothorax in 20 (24.7%), sternum and clavicular fractures in 6 (7.4%) and rib fractures in 21 (25.9%). The sensitivity and specificity of ultrasonography varied for detecting the following pathologies: subcutaneous emphysema (56% and 95%), pneumothorax (86% and 97%), hemothorax (45% and 98%), PCs (63% and 91%), sternal fractures (83% and 97%), clavicular fractures (83% and 100%) and rib fractures (67% and 98%), respectively. In conclusion, ultrasound was found to be highly specific but only moderately sensitive for the identification of thoracic injuries.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2018.08.002