Emergency Radiology

, Volume 20, Issue 2, pp 131–134 | Cite as

Value of ultrasound in diagnosis of pneumothorax: a prospective study

  • R. Jalli
  • S. Sefidbakht
  • S. H. JafariEmail author
Original Article


Transthoracic ultrasound (US) is useful in the evaluation of a wide range of peripheral parenchymal, pleural, and chest wall diseases. Furthermore, it is increasingly used to guide interventional procedures of the chest and pleural space. The role of chest US in the diagnosis of pneumothorax has been established, but comparison with lung computed tomography (CT) scanning has not yet been completely performed. The purpose of this study is to prospectively compare the accuracy of US with that of chest radiography in the detection of pneumothorax, with CT as the reference standard. One hundred ninety-seven patients who were evaluated by spiral chest CT scan for various clinical indications were prospectively evaluated. Ultrasonography was performed by a radiologist, blinded to the chest CT findings. Sensitivity, specificity, and accuracy of ultrasound in the detection of pneumothorax were then compared with chest CT scan. CT scan showed pneumothorax in 92 patients. Sonography and plain X-ray of the chest revealed 74 and 56 cases of pneumothorax, respectively. Statistical analysis disclosed the US to be 80.4 % sensitive and 89 % specific in the detection of pneumothorax with an overall accuracy of 85 %. In this study, US was more sensitive than chest radiography in the detection of pneumothorax. The results of this study suggest that thoracic US, when performed by trained individuals, can be helpful for the detection of pneumothorax.


Chest Ultrasonography Pneumothorax 



Our work was supported by the Medical Imaging Research Center, Radiology Department, Namazi Hospital, affiliated to Shiraz University of Medical Sciences, Shiraz, Iran.

Supplementary material


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  1. 1.
    Chee CB, Abisheganaden J, Yeo JK, Lee P, Huan PY, Poh SC, Wang YT (1998) Persistent air-leak in spontaneous pneumothorax—clinical course and outcome. Respir Med 92(5):757–761PubMedCrossRefGoogle Scholar
  2. 2.
    Killen D, Gobbel W. Spontaneous pneumothorax. Boston: Little, Brown; 2001Google Scholar
  3. 3.
    Schramel FM, Postmus PE, Vanderschueren RG (1997) Current aspects of spontaneous pneumothorax. Eur Respir J 10(6):1372–1379, ReviewPubMedCrossRefGoogle Scholar
  4. 4.
    Tocino IM, Miller MH, Fairfax WR (1985) Distribution of pneumothorax in the supine and semirecumbent critically ill adult. AJR Am J Roentgenol 144(5):901–905PubMedCrossRefGoogle Scholar
  5. 5.
    Wall SD, Federle MP, Jeffrey RB, Brett CM (1983) CT diagnosis of unsuspected pneumothorax after blunt abdominal trauma. AJR Am J Roentgenol 141(5):919–921PubMedCrossRefGoogle Scholar
  6. 6.
    Soldati G, Testa A, Sher S, Pignataro G, La Sala M, Silveri NG (2008) Occult traumatic pneumothorax: diagnostic accuracy of lung ultrasonography in the emergency department. Chest 133(1):204–211PubMedCrossRefGoogle Scholar
  7. 7.
    Rowan KR, Kirkpatrick AW, Liu D, Forkheim KE, Mayo JR, Nicolaou S (2002) Traumatic pneumothorax detection with thoracic US: correlation with chest radiography and CT—initial experience. Radiology 225(1):210–214PubMedCrossRefGoogle Scholar
  8. 8.
    Turk F, Kurt AB, Saglam S (2010) Evaluation by ultrasound of traumatic rib fractures missed by radiography. Emerg Radiol 17(6):473–477PubMedCrossRefGoogle Scholar
  9. 9.
    Sistrom CL, Reiheld CT, Gay SB, Wallace KK (1996) Detection and estimation of the volume of pneumothorax using real-time sonography: efficacy determined by receiver operating characteristic analysis. AJR Am J Roentgenol 166(2):317–321PubMedCrossRefGoogle Scholar
  10. 10.
    Goodman TR, Traill ZC, Phillips AJ, Berger J, Gleeson FV (1999) Ultrasound detection of pneumothorax. Clin Radiol 54(11):736–739PubMedCrossRefGoogle Scholar
  11. 11.
    Sartori S, Tombesi P, Trevisani L, Nielsen I, Tassinari D, Abbasciano V (2007) Accuracy of transthoracic sonography in detection of pneumothorax after sonographically guided lung biopsy: prospective comparison with chest radiography. AJR Am J Roentgenol 188(1):37–41PubMedCrossRefGoogle Scholar
  12. 12.
    Lichtenstein D, Meziere G, Biderman P, Gepner A (1999) The comet tail artifact: an ultrasound sign ruling out pneumothorax. Intensive Care Med 25:383–385PubMedCrossRefGoogle Scholar
  13. 13.
    Dente CJ, Ustin J, Feliciano DV, Rozycki GS, Wyrzykowski AD, Nicholas JM, Salomone JP, Ingram WL (2007) The accuracy of thoracic ultrasound for detection of pneumothorax is not sustained over time: a preliminary study. J Trauma 62(6):1384–1389PubMedCrossRefGoogle Scholar

Copyright information

© Am Soc Emergency Radiol 2012

Authors and Affiliations

  1. 1.Medical Imaging Research Center, Department of Radiology, Namazi HospitalShiraz University of Medical SciencesShirazIran

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