Olga Rachel Brook MD, Presenter: Nothing to Disclose

Zhanna Filatov, Abstract Co-Author: Nothing to Disclose

Anat Ilivitzki MD, Abstract Co-Author: Nothing to Disclose

Katerina Kouzemko, Abstract Co-Author: Nothing to Disclose

Nira Beck Razi, Abstract Co-Author: Nothing to Disclose

Diana Litmanovich MD, Abstract Co-Author: Nothing to Disclose

Saher Srour, Abstract Co-Author: Nothing to Disclose

Yoseph Abu Rahmah, Abstract Co-Author: Nothing to Disclose

Sobhi Abadi MD, Abstract Co-Author: Nothing to Disclose

Maxim Lederman, Abstract Co-Author: Nothing to Disclose

Moshe Michaelson, Abstract Co-Author: Nothing to Disclose

Diana E. Gaitini MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Recent articles report that ultrasound may be used to diagnose pneumothorax, although the gold standard is chest CT. In this study we assessed the accuracy of sonographic pneumothorax detection performed by radiology residents as a part of extended Focused Assessment with Sonography for Trauma (eFAST).

The study prospectively included all trauma room patients, admitted when one of the study participants was on call. Sonographic detection of pneumothorax was performed as a part of a standard eFAST examination by the on-call resident. Normal pleural interface was identified on US by the presence of lung sliding and comet-tail artifact. Absence of these normal features diagnosed pneumothorax. Every lung field was scanned at two sites: 2nd to 4th intercostal space anteriorly and 6th to 8th space in midaxillary line with a convex transducer, 3.5 MHz frequency. The results were correlated with supine chest X-ray done in the trauma room and chest CT. The study protocol was approved by the institutional review board with waiver of informed consent.

One hundred sixty nine patients (338 lung fields) that underwent eFAST, CXR and chest CT were included in this study. Pneumothorax was identified in 43 lung fields (13%) on chest CT, of them 33 were minor and 10 moderate. Seven (16%) pneumothoraces were identified on chest X-ray. Twenty three pneumothoraces were identified by ultrasound (sensitivity of 53%, specificity 100%, PPV 100%, NPV 94%). All cases of moderate pneumothorax were identified by ultrasound. Twenty cases of minor pneumothorax that were not identified by ultrasound did not require any treatment during the whole hospitalization period.

In this prospective study we found that ultrasound performed by radiology residents is an accurate tool for detection of moderate pneumothorax. Pneumothorax that was not detected by ultrasound was of minor degree only and did not require any treatment.

Significant pneumothorax can be accurately detected by on-call radiology residents, as a part of extended Focused Abdominal Sonography in Trauma (eFAST).

Brook, O, Filatov, Z, Ilivitzki, A, Kouzemko, K, Beck Razi, N, Litmanovich, D, Srour, S, Abu Rahmah, Y, Abadi, S, Lederman, M, Michaelson, M, Gaitini, D, et al, , et al, , Sonographic Detection of Pneumothorax by Radiology Residents as a Part of Extended Focused Assessment with Sonography for Trauma (eFAST).  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5004215.html