Kılıç Burcu, Khoraki Yaman, Sağlam Ömer Faruk, Özçıbık Işık Gizem, Turan Tolunay, Erşen Ezel, Kara H Volkan, Turna Akif, Kaynak Kamil
Department of Thoracic Surgery, Istanbul University - Cerrahpasa, Istanbul, Turkey.
Thoracic Surgery, Tokat State Hospital, Tokat, Turkey.
Kardiochir Torakochirurgia Pol. 2025 Mar;22(1):1-7. doi: 10.5114/kitp.2025.148550. Epub 2025 Mar 17.
Thoracic ultrasound (US) is a practical tool in radiology that has been commonly used for decades. Its daily clinic use in thoracic surgery is rising, and scientific evidence is needed to support its use.
We aimed to determine the diagnostic value of handheld, portable thoracic ultrasound scanning (HH-US) in patients referred to the thoracic surgery outpatient clinic with suspected pleural effusion and compare the diagnostic role with chest X-rays (CXR) or computed tomography (CT).
We analyzed the patients between 2020 and 2023 who were referred to our outpatient clinic with various symptoms and having differential diagnosis of pleural effusion. In total, 91 patients fulfilled the inclusion criteria. Ultrasonographic (US) scans were performed by thoracic surgeons who were educated and certified in ultrasonography training. All patients underwent US first and then were referred for chest X-ray or computed tomography. All the results were compared focusing on the efficacy of US initially. If the amount of the effusion required drainage, thoracentesis was carried out with US support. The indications, methods, time, and related complications, with demographic data of the patients were recorded and analyzed.
There were 57 (62.6%) male and 34 female (37.4%) patients. Only diagnostic thoracentesis was performed in 16 patients, catheter thoracostomy was performed in 47 patients, minimal effusion not requiring pleural intervention was observed in 6 patients (2 patients were trauma patients who applied to the emergency department), minimal effusion was detected in 14 patients, and no intervention was performed. No complications were observed. The sensitivity of US in detecting fluid effusion compared to CXR was 83.3%, while its sensitivity compared to thorax computed tomography (CT) was 88.5%.
Proficient thoracic surgeons can effectively employ ultrasound devices for diagnosing and managing pleural effusions. This would be helpful for decision making and treatment.
胸部超声（US）是放射学中一种实用的工具，已经被广泛使用了几十年。其在胸外科的日常临床应用正在增加，需要科学证据来支持其使用。
我们旨在确定手持式、便携式胸部超声扫描（HH-US）对因疑似胸腔积液而转诊至胸外科门诊的患者的诊断价值，并将其诊断作用与胸部X线（CXR）或计算机断层扫描（CT）进行比较。
我们分析了2020年至2023年间因各种症状转诊至我们门诊且有胸腔积液鉴别诊断的患者。共有91名患者符合纳入标准。超声（US）扫描由接受过超声检查培训并获得认证的胸外科医生进行。所有患者先进行超声检查，然后转诊进行胸部X线或计算机断层扫描。所有结果首先重点比较超声检查的有效性。如果积液量需要引流，则在超声引导下进行胸腔穿刺术。记录并分析患者的适应证、方法、时间、相关并发症及人口统计学数据。
男性患者57例（62.6%），女性患者34例（37.4%）。16例患者仅进行了诊断性胸腔穿刺术，47例患者进行了胸腔置管引流术，6例患者观察到少量积液无需胸膜干预（2例为就诊于急诊科的创伤患者），14例患者检测到少量积液，未进行干预。未观察到并发症。与胸部X线相比，超声检测胸腔积液的敏感性为&3.3%，与胸部计算机断层扫描（CT）相比，其敏感性为88.5%。
熟练的胸外科医生可以有效地使用超声设备诊断和处理胸腔积液。这将有助于决策和治疗。
