Role of thoracic ultrasonography in diagnosis of different chest diseases

Background
Thoracic ultrasonography (TUS) is a low-cost, noninvasive, practical, and rapid method for visualization of different respiratory disorders. Previous reports showed a high sensitivity, specificity, and diagnostic accuracy (96.8%) of TUS in the diagnosis of different chest diseases.


Objective
The aims were to assess the diagnostic accuracy of chest ultrasound (US) in the diagnosis of different chest diseases and to compare its accuracy with currently available imaging techniques.


Patients and methods
A prospective study was conducted on 213 patients. The patients were categorized according to their respiratory disorders into five groups (parenchymal, pleural, vascular, airway disease, and diaphragmatic dysfunctions). Chest radiography, computed tomography, and TUS were done for each group and were compared together. US chest examination was done using gray-scale (B-mode) or time-motion mode (M-mode).


Results
In patients with pneumonia, the sensitivity of US and radiography was 97.5 and 90.6%, respectively. In interstitial group patients, the sensitivity of US and radiography was 95.7 and 100%, respectively. In patients with lung mass, the sensitivity of US and radiography was 88.2 and 94.1%, respectively. In patients with cavitary lesion, the sensitivity of US and radiography was 100 and 87.5%, respectively. The sensitivity of US in detecting pleural effusion was 100% with accuracy of 100%. However, chest radiography showed 93.1% sensitivity and accuracy in detecting pleural effusion. The sensitivity and accuracy of both US and chest radiography in detecting vascular diseases were the same.


Conclusion
TUS is a useful tool in the diagnosis of different respiratory disorders especially in the diagnosis of pleural and diaphragmatic disorders. In addition, US offers a number of advantages of being easily performed by clinicians at the point of care, inexpensive, and avoiding exposure to radiation.