比较肺部超声与胸部X线摄影对创伤患者气胸的诊断效能：一项Meta分析
Comparing the Diagnostic Performance of Lung Ultrasonography and Chest Radiography for Detecting Pneumothorax in Patients with Trauma: A Meta-Analysis.
作者信息
Sheng Bo, Tao Lili, Zhong Congbing, Gao Ling
机构信息
Department of Ultrasound, Wuxi Hospital of Traditional Chinese Medicine, Wuxi, China.
出版信息
Respiration. 2025;104(3):161-175. doi: 10.1159/000540777. Epub 2024 Sep 30.
INTRODUCTION
The objective of this study was to compare the diagnostic performance of ultrasonography (US) and chest radiography for detecting pneumothorax in patients with trauma using a meta-analytic approach.
METHODS
PubMed, Embase, and the Cochrane Library were systematically searched to identify eligible studies until March 2023. The diagnostic performance of US and chest radiography was assessed using sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic score, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC).
RESULTS
Overall, 21 studies involving 4,087 patients with trauma were included. The overall sensitivity, specificity, PLR, NLR, diagnostic score, DOR, and AUC of US for detecting pneumothorax were 0.83, 0.99, 73.72, 0.17, 6.06, 427.80, and 0.99, respectively. The corresponding values of chest radiography for detecting pneumothorax were 0.37, 1.00, 175.59, 0.63, 5.63, 279.97, and 0.86. US was associated with a higher sensitivity (ratio: 2.24; 95% confidence interval [CI]: 1.70-2.95; p < 0.001) or AUC (ratio: 1.15; 95% CI: 1.11-1.19; p < 0.001) and lower NLR (ratio: 0.27; 95% CI: 0.17-0.43; p < 0.001) compared with chest radiography.
CONCLUSION
Lung US was associated with better diagnostic performance than chest radiography for detecting pneumothorax in patients with trauma.
INTRODUCTION
The objective of this study was to compare the diagnostic performance of ultrasonography (US) and chest radiography for detecting pneumothorax in patients with trauma using a meta-analytic approach.
METHODS
PubMed, Embase, and the Cochrane Library were systematically searched to identify eligible studies until March 2023. The diagnostic performance of US and chest radiography was assessed using sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic score, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC).
RESULTS
Overall, 21 studies involving 4,087 patients with trauma were included. The overall sensitivity, specificity, PLR, NLR, diagnostic score, DOR, and AUC of US for detecting pneumothorax were 0.83, 0.99, 73.72, 0.17, 6.06, 427.80, and 0.99, respectively. The corresponding values of chest radiography for detecting pneumothorax were 0.37, 1.00, 175.59, 0.63, 5.63, 279.97, and 0.86. US was associated with a higher sensitivity (ratio: 2.24; 95% confidence interval [CI]: 1.70-2.95; p < 0.001) or AUC (ratio: 1.15; 95% CI: 1.11-1.19; p < 0.001) and lower NLR (ratio: 0.27; 95% CI: 0.17-0.43; p < 0.001) compared with chest radiography.
CONCLUSION
Lung US was associated with better diagnostic performance than chest radiography for detecting pneumothorax in patients with trauma.
引言
本研究的目的是采用荟萃分析方法比较超声检查（US）和胸部X线摄影对创伤患者气胸的诊断性能。
方法
系统检索PubMed、Embase和Cochrane图书馆，以识别符合条件的研究，检索截至2023年3月。使用敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）、诊断分数、诊断比值比（DOR）和受试者工作特征曲线下面积（AUC）评估US和胸部X线摄影的诊断性能。
结果
总体而言，纳入了21项涉及4087例创伤患者的研究。US检测气胸的总体敏感性、特异性、PLR、NLR、诊断分数、DOR和AUC分别为0.83、0.99、73.72、0.17、6.06、427.80和0.99。胸部X线摄影检测气胸的相应值为0.37、1.00、175.59、0.63、5.63、279.97和0.86。与胸部X线摄影相比，US具有更高的敏感性（比值：2.24；95%置信区间[CI]：1.70 - 2.95；p < .001）或AUC（比值：1.15；95%CI：1.11 - 1.19；p < .001）以及更低的NLR（比值：0.27；95%CI：0.17 - 0.43；p < .001）。
结论
对于创伤患者气胸的检测，肺部超声检查比胸部X线摄影具有更好的诊断性能。
引言
本研究的目的是采用荟萃分析方法比较超声检查（US）和胸部X线摄影对创伤患者气胸的诊断性能。
方法
系统检索PubMed、Embase和Cochrane图书馆，以识别符合条件的研究，检索截至2023年3月。使用敏感性、特异性、阳性似然比（PLR）、阴性似然比（NLR）、诊断分数、诊断比值比（DOR）和受试者工作特征曲线下面积（AUC）评估US和胸部X线摄影的诊断性能。
结果
总体而言，纳入了21项涉及4087例创伤患者的说研究。US检测气胸的总体敏感性、特异性、PLR、NLR、诊断分数、DOR和AUC分别为0.83、0.99、73.72、0.17、6.06、427.80和0.99。胸部X线摄影检测气胸的相应值为0.37、1.00、175.59、0.63、5.63、279.97和0.86。与胸部X线摄影相比，US具有更高的敏感性（比值：2.24；95%置信区间[CI]：1.70 - 2.95；p < .001）或AUC（比值：1.15；95%CI：1.11 - 1.19；p < .001）以及更低的NLR（比值：0.27；95%CI：0.17 - 0.43；p < .001）。
结论
对于创伤患者气胸的检测，肺部超声检查比胸部X线摄影具有更好的诊断性能。
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