How successful is “pleural sound sign” in the identification of pneumothorax?

Abstract

OBJECTIVE: In the present study, in thorax ultrasonography (USG) Doppler images obtained from cases with occult pneumothorax, we investigated the status of pulsatile pleural sounds over the pleural line and called these as the pleural soundsign (PSS). The purpose of the present study was to identify the efficacy of the proposed PSS in diagnosing pneumothoraxand to compare it with the other USG findings including the sliding lung sign (SLS) and seashore sign (SSS).METHODS: The present study included 66 consecutive patients who were referred to the emergency unit with a blunttrauma from October 2009 to January 2010 at a tertiary university hospital.RESULTS: Of the 66 patients, 34 were in the patient group, and 32 were in the control group. Males accounted for 66.7%(n=44) of the study population. In predicting pneumothorax, the areas under receiver operating characteristic (ROC) curvesof PSSmax and PSSdifference were 0.989 and 0.990, respectively. While the sensitivity of the SLS was 88% and the sensitivityof the SSS was 56%, the specificities of the SLS and SSS were 100%. Based on our findings, accuracy ranking was as follows:PSSmax = PSSdifference > SLS > SSS.CONCLUSION: New applications of thorax USG are rapidly growing. Our findings have to be confirmed in a large patientseries. PSS is not a novel method, but it enhanced the importance of USG in the diagnosis of pneumothorax. We can stipulatethat it can replace thorax computed tomography imaging particularly for the diagnosis of occult pneumothoraxes.