초록접수 현황
| 17F-168 | 포럼 발표 |
Is Really Thoracic Sonography Useful in Detection of Traumatic Pneumothorax?
Chun Sung Byun, Chang Wan Kim, Kwan Wook Kim, Soonchang Hong, Joong Hwan Oh
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
Purpose : between the second and fourth intercostal spaces at the midclavicular line and the sixth to eighth spaces in the midaxillary line, for a total of 4 views. The purpose of this study was to assess the accuracy of eFAST for traumatic pneumothorax detection and its usefulness.
Methods : We retrospectively analyzed 168 trauma patients over 2 years in whom eFAST was performed in blunt thoracic trauma. The demographics, type of injury, chest AP, eFAST and CT scan findings were reported. Pneumothorax dimension in CT is defined the largest diameter of the air pocket along a line perpendicular to the inner chest wall in area from parasternal to midaxillary line.
Results : Of 168 patients with 336 lung fields, 120 (35.7%) fields had pneumothorax in CT. The thoracic sonography was positive in 82 (true positive 81, false positive 1, false negative 39, true negative 215). Sensitivity and specificity is 67.5% and 99.5%. The thresholds for pneumothorax dimension in CT and thoracic sonography positive were determined using ROC analysis (AUC 0.806), all dimension ≥11mm pneumothorax diagnosed truly in thoracic sonography. But <11mm, 39 of 49 (79.6%) pneumothorax did not diagnose in thoracic sonography (p<0.001). The pneumothorax <11mm tend to locate in below the 5th ICS around the heart and diaphragm margin (p<0.001).
Conclusion : The thoracic sonography for blunt thoracic trauma failed to diagnose in small pneumothorax (<11mm). So, we should add the anterolateral chest wall scanning below the 5th ICS around the heart and diaphragm margin in thoracic trauma patients for increasing sensitivity.
Methods : We retrospectively analyzed 168 trauma patients over 2 years in whom eFAST was performed in blunt thoracic trauma. The demographics, type of injury, chest AP, eFAST and CT scan findings were reported. Pneumothorax dimension in CT is defined the largest diameter of the air pocket along a line perpendicular to the inner chest wall in area from parasternal to midaxillary line.
Results : Of 168 patients with 336 lung fields, 120 (35.7%) fields had pneumothorax in CT. The thoracic sonography was positive in 82 (true positive 81, false positive 1, false negative 39, true negative 215). Sensitivity and specificity is 67.5% and 99.5%. The thresholds for pneumothorax dimension in CT and thoracic sonography positive were determined using ROC analysis (AUC 0.806), all dimension ≥11mm pneumothorax diagnosed truly in thoracic sonography. But <11mm, 39 of 49 (79.6%) pneumothorax did not diagnose in thoracic sonography (p<0.001). The pneumothorax <11mm tend to locate in below the 5th ICS around the heart and diaphragm margin (p<0.001).
Conclusion : The thoracic sonography for blunt thoracic trauma failed to diagnose in small pneumothorax (<11mm). So, we should add the anterolateral chest wall scanning below the 5th ICS around the heart and diaphragm margin in thoracic trauma patients for increasing sensitivity.
책임저자: Joong Hwan Oh
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Chun Sung Byun, E-mail : csbyun@yonsei.ac.kr