Diagnostic Accuracy of Chest Ultrasonography for Pneumothorax in Post Traumatic Patient taking CT as a gold standard

Background: It is vital to diagnose pneumothorax at early stage for treatment purpose. In trauma cases usually it is ignored and remains undiagnosed which can become cause of tension pneumothorax and cardiac arrest. Ultrasound has helped the trauma cases to diagnose pneumothorax by performing chest ultrasound and can manage the treatment plan and resuscitation. Aim: To analyze the diagnostic accuracy of chest ultrasound in identifying the pneumothorax from trauma cases while CT remain as a gold standard. Methodology: The trauma patients who were referred to Radiology Department of Lahore General Hospital from the period of January 2019 to January 2020 were included in the study. Total 152 patients were included in the study. The ultrasound chest was performed in suspected chest trauma patients. Scan was done in supine position by using high frequency linear probe by focusing on both lungs and identifying the parietal pleura, visceral pleura, comet tail artifact and lung sliding which shows normal lungs. The gold standard set was CT chest results. Results: Total of 152 patients who have chest trauma were included and the mean age of the selected sample was 31.6 +/- 13.4 years (range: 5-68).Male patients were more in number (76%).Pneumothorax was found in 55 cases which counts 36.2% of the total cases. The sensitivity of the ultrasound was 83.6%. Specificity of the ultrasound was 97.9%. Positive predictive value of ultrasound was 95.8% and negative predictive value 91.3%. Conclusion: Chest ultrasound is accurate, no exposure to radiation and quick technique to identify the pneumothorax in trauma patients presenting in emergency department.