Akciğer ve plevra hastalıklarında toraks ultrasonografisinin tanısal değeri
Küçük Resim Yok
Tarih
2014
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Akciğer ve plevra patolojilerinde toraks ultrasonografisi bilgisayarlı tomografi ile akciğer grafisine göre daha yüksek uyum gösterir. Bununla birlikte toraks ultrasonografisinin hangi tür prob ile yapıldığında tanısal değerinin daha yüksek olacağı açık değildir. Çalışmamızın birincil amacı pnömotoraks, plevral efüzyon, konsolidasyon ve interstisyel sendrom gibi temel toraks patolojilerini saptamada düşük frekanslı prob ile yüksek frekanslı probun tanısal değerlerini karşılaştırmak olup, ikincil amacı da toraks ultrasonografisinin, oskültasyon ve akciğer grafisine göre tanısal başarısını test etmekti. Trakya Üniversitesi Tıp Fakültesi Göğüs Hastalıkları servisinde yatarken toraks bilgisayarlı tomografisi çekilen ardışık 55 hasta prospektif olarak çalışmaya alındı. Hastalar pnömotoraks, plevral efüzyon, konsolidasyon ve interstisyel sendrom açısından toraks bilgisayarlı tomografisi, toraks ultrasonografisi, akciğer grafisi ve oskültasyon ile bağımsız ve kör olarak değerlendirildi. Toraks ultrasonografisinde lineer ve sektör problardan ilk uygulanacak olanı randomize olarak belirlendi. Toraks ultrasonografisi, akciğer grafisi ve oskültasyon bulguları toraks bilgisayarlı tomografi bulguları ile karşılaştırıldı. Lineer prob pnömotoraks (duyarlılık %83, özgüllük %100, tanısal doğruluk %99) ve plevral efüzyonda (duyarlılık %100, özgüllük %97, tanısal doğruluk %98); sektör prob ise konsolidasyon (duyarlılık %89, özgüllük %100, tanısal doğruluk %95) ve interstisyel sendromda (duyarlılık %94, özgüllük %93, tanısal doğruluk %94) en yüksek başarıyı gösterdi. Tüm patolojilerde ultrasonografinin başarısını sırasıyla akciğer grafisi ve oskültasyon izledi. Sonuç olarak; akciğer ve plevra hastalıklarında toraks ultrasonografisinin tanısal değeri oskültasyon ve akciğer grafisine göre yüksek olup, patolojiye göre prob seçimi önem taşımaktadır. Plevral patolojilerde lineer prob sektör proba üstün bulunurken, parankimal patolojilerde sektör prob lineer proba üstün bulunmuştur. Çalışmamız torasik ultrasonografinin yalnız acil ve yoğun bakımda değil göğüs hastalıkları kliniklerinde de kullanışlı olduğunu göstermiştir. Anahtar kelimeler: Toraks ultrasonografisi, akciğer ve plevra hastalıkları, prob, tanı
Thoracic ultrasonography has a higher correlation with thoracic computed tomography compared with chest radiography in the assessment of lung and pleural diseases. However, diagnostic values of different types of probes used for thoracic ultrasonography is not clear. The primary purpose of our study was to compare the diagnostic values of low-frequency and high-frequency probes in detecting basic thoracic pathologies such as pneumothorax, pleural effusion, consolidation and interstitial syndrome; secondary purpose was to compare the diagnostic performance of thoracic ultrasonography with auscultation and chest radiography. 55 consecutive patients who underwent thoracic computed tomography during hospitalization in Trakya University Medical Faculty Chest Diseases Department, enrolled in the study prospectively. Patients were evaluated by thorax computed tomography, thoracic ultrasonography, chest radiography and auscultation for pneumothorax, pleural effusion, consolidation and interstitial syndrome independently and blindly. The linear and sector probes firstly used in thoracic ultrasonography were selected randomly. Thoracic ultrasonography, chest radiography and auscultation results compared with the results of computed tomography. Linear probe has the highest performance in the pneumothorax (sensitivity 83%, specificity 100%, diagnostic accuracy 99%) and pleural effusion (sensitivity 100%, specificity 97%, diagnostic accuracy 98%) and the sector probe has the highest performance in the consolidation (sensitivity 89%, specificity 100%, diagnostic accuracy 95%) and interstitial syndrome (sensitivity 94%, specificity 93%, diagnostic accuracy 94%). The performance of ultrasonography in all pathologies were followed by chest radiography and auscultation, respectively. In conclusion, the diagnostic value of ultrasonography in lung and pleural diseases is higher compared to the chest radiography and auscultation and pathology based probe selection is important. Linear probe is superior to sector probe for pleural pathologies, whereas the sector probe is superior to linear probe for parenchymal pathologies. Our study have shown that the thoracic ultrasonography is also useful in chest diseases clinics not only in emergency and intensive care units. Key words: Thoracic ultrasonography, lung and pleural diseases, probe, diagnosis
Thoracic ultrasonography has a higher correlation with thoracic computed tomography compared with chest radiography in the assessment of lung and pleural diseases. However, diagnostic values of different types of probes used for thoracic ultrasonography is not clear. The primary purpose of our study was to compare the diagnostic values of low-frequency and high-frequency probes in detecting basic thoracic pathologies such as pneumothorax, pleural effusion, consolidation and interstitial syndrome; secondary purpose was to compare the diagnostic performance of thoracic ultrasonography with auscultation and chest radiography. 55 consecutive patients who underwent thoracic computed tomography during hospitalization in Trakya University Medical Faculty Chest Diseases Department, enrolled in the study prospectively. Patients were evaluated by thorax computed tomography, thoracic ultrasonography, chest radiography and auscultation for pneumothorax, pleural effusion, consolidation and interstitial syndrome independently and blindly. The linear and sector probes firstly used in thoracic ultrasonography were selected randomly. Thoracic ultrasonography, chest radiography and auscultation results compared with the results of computed tomography. Linear probe has the highest performance in the pneumothorax (sensitivity 83%, specificity 100%, diagnostic accuracy 99%) and pleural effusion (sensitivity 100%, specificity 97%, diagnostic accuracy 98%) and the sector probe has the highest performance in the consolidation (sensitivity 89%, specificity 100%, diagnostic accuracy 95%) and interstitial syndrome (sensitivity 94%, specificity 93%, diagnostic accuracy 94%). The performance of ultrasonography in all pathologies were followed by chest radiography and auscultation, respectively. In conclusion, the diagnostic value of ultrasonography in lung and pleural diseases is higher compared to the chest radiography and auscultation and pathology based probe selection is important. Linear probe is superior to sector probe for pleural pathologies, whereas the sector probe is superior to linear probe for parenchymal pathologies. Our study have shown that the thoracic ultrasonography is also useful in chest diseases clinics not only in emergency and intensive care units. Key words: Thoracic ultrasonography, lung and pleural diseases, probe, diagnosis
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Göğüs Hastalıkları, Chest Diseases
