Karimi Ebrahim
1. Emergency Department, Be'sat Hospital, AJA University of Medical Sciences, Tehran, Iran.
Arch Acad Emerg Med. 2019 Jan 22;7(1):e8. eCollection 2019 Winter.
Rapid detection of pneumonia and early initiation of antibiotic therapy are associated with better prognosis in patients. The present study was designed aiming to evaluate the sensitivity of chest ultrasonography performed by emergency medicine specialists in detection of pneumonia and comparing it with plain radiography.
In the present diagnostic accuracy study, patients presenting to the emergency department with clinical symptoms of lung infection underwent plain radiography, ultrasonography, and computed tomography (CT) scan of chest and the screening performance characteristics of plain radiography and ultrasonography were compared considering CT scan findings as the gold standard.
280 patients with the mean age of 56.47 ± 19.79 (10 - 92) years were studied (57.1% male). The results of chest CT scan were indicative of infection symptoms being present and confirmed pneumonia diagnosis for all the patients. Out of the 280 cases of pneumonia confirmed via chest CT scan, 17 (6.1%) cases were not detected via ultrasonography and 48 (17.1%) cases were missed by chest radiography (false negative cases). No false positive case was reported by ultrasonography or chest x-ray. Since all of the CT scans were positive, no comment can be made regarding the specificity of the evaluated tests, but sensitivity of ultrasonography and plain radiography were 93.92 (90.28 - 96.31) and 82.85 (77.81 - 86.97), respectively (p = 0.583).
Based on the findings of the present study, although the sensitivity of ultrasonography in detection of pneumonia was significantly higher than chest x-ray, overall the screening performance characteristics of the 2 tests were not significantly different. Therefore, considering characteristics such as safety, low cost, being portable, and being available, ultrasonography seems to be a reasonable tool for screening and diagnosis of patients with pneumonia.
快速检测肺炎并尽早开始抗生素治疗与患者更好的预后相关。本研究旨在评估急诊医学专家进行的胸部超声检查在检测肺炎方面的敏感性，并将其与胸部X光片进行比较。
在本诊断准确性研究中，因肺部感染临床症状就诊于急诊科的患者接受了胸部X光片、超声检查和胸部计算机断层扫描（CT），并将胸部X光片和超声检查的筛查性能特征与以CT扫描结果作为金标准进行比较。
研究了280例平均年龄为56.47±19.79（10 - 92）岁的患者（57.1%为男性）。胸部CT扫描结果显示所有患者均存在感染症状并确诊为肺炎。在通过胸部CT扫描确诊的280例肺炎病例中，17例（6.1%）未通过超声检查检测到，48例（17.1%）被胸部X光片漏诊（假阴性病例）。超声检查或胸部X光片均未报告假阳性病例。由于所有CT扫描均为阳性，因此无法对所评估检查的特异性发表评论，但超声检查和胸部X光片的敏感性分别为93.92（范围90.28 - 96.31）和82.85（范围77.81 - 86.97）（p = 0.583）。
基于本研究结果，虽然超声检查在检测肺炎方面的敏感性显著高于胸部X光片，但总体而言这两种检查的筛查性能特征并无显著差异。因此，考虑到安全性、低成本、便携性和可用性等特点，超声检查似乎是筛查和诊断肺炎患者的合理工具。
