DIAGNOSTIC ACCURACY OF CHEST ULTRASONOGRAPHY FOR DETECTION OF PNEUMOTHORAX IN POST TRAUMATIC PATIENTS TAKING COMPUTED TOMOGRAPHY SCAN CHEST AS GOLD STANDARD: A CROSS-SECTIONAL STUDY
DOI:
https://doi.org/10.71000/4nr1ja90Keywords:
Accuracy, Chest CT, Emergency Medicine, Pleural Air, Pneumothorax, Trauma, Ultrasonography, Wounds and InjuriesAbstract
Background: Pneumothorax is a critical condition characterized by the accumulation of air in the pleural cavity, leading to partial or complete lung collapse. Rapid and accurate diagnosis is essential to prevent morbidity and mortality. Computed tomography (CT) is considered the gold standard for diagnosis; however, its high cost, limited accessibility, and time constraints in emergency settings necessitate alternative diagnostic modalities. Chest ultrasonography has emerged as a valuable, non-invasive, and rapid diagnostic tool, particularly in trauma care.
Objective: To determine the diagnostic accuracy of chest ultrasonography in detecting pneumothorax among post-traumatic patients, using CT chest as the gold standard.
Methods: This cross-sectional validation study was conducted in the Department of Radiology, Khyber Teaching Hospital, Peshawar, over six months following ethical approval. A total of 128 post-traumatic patients aged 18–75 years were enrolled through consecutive non-probability sampling. Each patient underwent both ultrasound and CT scan examinations. Pneumothorax on ultrasound was defined by the absence of lung sliding and comet-tail artifacts, while CT detection included visualization of pleural air, small pneumothoraces, and blebs. Diagnostic indices—sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy—were calculated using CT as the reference standard.
Results: Ultrasound detected pneumothorax in 76 patients (59.4%), while CT confirmed 81 cases (63.3%). Cross-tabulation revealed 70 true positives, 41 true negatives, 6 false positives, and 11 false negatives. The sensitivity, specificity, PPV, NPV, and overall accuracy of ultrasound were 86.4%, 87.2%, 92.1%, 78.8%, and 86.7%, respectively.
Conclusion: Chest ultrasonography demonstrated high diagnostic accuracy in identifying pneumothorax among trauma patients and serves as a reliable alternative to CT scanning, especially in emergency and resource-limited environments where rapid bedside assessment is crucial.
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Copyright (c) 2025 Muhammad Khadim, Humaira Anjum, Iqra Sardar, Raina Gul, Aisha Iqbal, Abuzar Ali (Author)
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