Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University, School of Medicine and Research Institute of Emergency Medicine, Zhejiang University, Hangzhou, China.
Department of Burns, Second Affiliated Hospital, Zhejiang University, Hangzhou, China.
Chest. 2011 Oct;140(4):859-866. doi: 10.1378/chest.10-2946. Epub 2011 May 5.
This study compares, by meta-analysis, the use of anterior-posterior chest radiography (CR) with transthoracic ultrasonography for the diagnosis of pneumothorax.
English-language articles on the performance of CR and ultrasonography in the diagnosis of a pneumothorax were selected. In eligible studies, data were recalculated, and the forest plots and summary receiver operating characteristic (sROC) curves were analyzed.
Pooled sensitivity and specificity were 0.88 and 0.99, respectively, for ultrasonography, and 0.52 and 1.00, respectively, for CR. For ultrasonography performed by clinicians other than radiologists, pooled sensitivity and specificity were 0.89 and 0.99, respectively. The sROC areas under the curve were compared, and no significant differences between ultrasonography and CR were found. Meta-regression analysis implied that the operator is strongly associated with accuracy (relative diagnostic OR, 0.21; 95% CI, 0.05-0.96; P = .0455).
The meta-analysis indicated that bedside ultrasonography performed by clinicians had higher sensitivity and similar specificity compared with CR in the diagnosis of pneumothorax, but the accuracy of ultrasonography in the diagnosis of pneumothorax depended on the skill of the operators.
本研究通过荟萃分析比较前后位胸部 X 线摄影（CR）与经胸超声在气胸诊断中的应用。
选择了关于 CR 和超声在气胸诊断中的性能的英文文献。在合格的研究中，重新计算了数据，并分析了森林图和汇总受试者工作特征（sROC）曲线。
超声的合并敏感性和特异性分别为 0.88 和 0.99，CR 的分别为 0.52 和 1.00。对于非放射科医生进行的超声检查，合并敏感性和特异性分别为 0.89 和 0.99。比较了 sROC 曲线下面积，超声与 CR 之间无显著差异。Meta 回归分析表明，操作者与准确性密切相关（相对诊断比值比，0.21；95%置信区间，0.05-0.96；P =.0455）。
荟萃分析表明，临床医生床边进行的超声检查在气胸诊断中具有较高的敏感性和相似的特异性，与 CR 相比，但超声诊断气胸的准确性取决于操作者的技能。
