Comparative Evaluation of Lung Contusion Assessment Using Ultrasound and Computed Tomography Scan in the First 24 Hours of Intensive Care Unit Admission

Introduction: Lung contusion is a common condition often resulting from blunt trauma, and it is connected with substantial health complications and risk of death; therefore, timely diagnosis and treatment are essential. Ultrasonography is a valuable technique that significantly improves medical car...

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Main Authors: Reza Alizadeh Kashani, Sevak Hatamian, Mohammad Reza Maghsoudi, Mahnaz Zoghi
Format: Article
Language:English
Published: Knowledge E 2024-12-01
Series:Dubai Medical Journal
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Online Access:https://www.knepublishing.com/index.php/DMJ/article/view/17806
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author Reza Alizadeh Kashani
Sevak Hatamian
Mohammad Reza Maghsoudi
Mahnaz Zoghi
author_facet Reza Alizadeh Kashani
Sevak Hatamian
Mohammad Reza Maghsoudi
Mahnaz Zoghi
author_sort Reza Alizadeh Kashani
collection DOAJ
description Introduction: Lung contusion is a common condition often resulting from blunt trauma, and it is connected with substantial health complications and risk of death; therefore, timely diagnosis and treatment are essential. Ultrasonography is a valuable technique that significantly improves medical care, offering time efficiency and lifesaving benefits. This study aimed to evaluate lung contusion by comparing the use of ultrasound and computed tomography (CT) scan during the initial 24 hr of intensive care unit (ICU) hospitalization. Methods: Eighty patients with blunt chest trauma were enrolled in this study. Each patient underwent both chest CT scan and lung ultrasound examinations. Lung ultrasound was performed in 6 anatomical regions on each lung (anterior-superior, anteriorinferior, lateral-superior, lateral-inferior, posterior-superior, and posterior-inferior). Lung contusion was identified by observing localized pulmonary effusion along with disrupting the lung parenchyma. To evaluate the extent of lung damage, the ratio of partial pressure of oxygen in arterial blood to the fraction of inspired oxygen concentration (PaO2/FiO2 ratio) was utilized, while the extent of lung involvement was classified using the blunt pulmonary contusion score (BPC-18 score). Results: In this study, lung ultrasonography demonstrated a sensitivity of 93.6% for detecting lung contusions, with a specificity of 94.1%, positive predictive value (PPV) of 98.3%, negative predictive value (NPV) of 80%, and overall accuracy of 93.7%. Specifically, for the right lung, these measures were 90.9%, 96%, 98%, 82.7%, and 92.5%, respectively. For the left lung, the corresponding values were 88%, 96.6%, 97.7%, 82.8%, and 91.2%. The receiver operating characteristics (ROC) curve assessed the sensitivity and specificity of ultrasound in diagnosing lung contusions within the first 24 hr of ICU admission. The area under the curve (AUC) for this assessment was 0.939, indicating high diagnostic accuracy. Conclusion: While CT remains the standard for evaluating lung contusions, its accessibility may be limited due to various circumstances, especially during hemodynamic instability. In these situations, ultrasound is highly valuable in diagnosing lung contusions with exceptional sensitivity, specificity, and diagnostic accuracy. Chest ultrasound emerges as an essential, noninvasive, and safe diagnostic tool at the bedside in the ICU for detecting lung contusions.
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spelling doaj-art-0d0cfafd4a1d454db901014bf517bf6a2025-08-20T02:43:06ZengKnowledge EDubai Medical Journal2571-726X2024-12-017410.18502/dmj.v7i4.17806Comparative Evaluation of Lung Contusion Assessment Using Ultrasound and Computed Tomography Scan in the First 24 Hours of Intensive Care Unit AdmissionReza Alizadeh Kashani0Sevak Hatamian1Mohammad Reza Maghsoudi2Mahnaz Zoghi3Department of Anesthesia, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, KarajDepartment of Anesthesia, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, KarajDepartment of Emergency Medicine and Toxicology Emergency, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, KarajDepartment of Anesthesia, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj Introduction: Lung contusion is a common condition often resulting from blunt trauma, and it is connected with substantial health complications and risk of death; therefore, timely diagnosis and treatment are essential. Ultrasonography is a valuable technique that significantly improves medical care, offering time efficiency and lifesaving benefits. This study aimed to evaluate lung contusion by comparing the use of ultrasound and computed tomography (CT) scan during the initial 24 hr of intensive care unit (ICU) hospitalization. Methods: Eighty patients with blunt chest trauma were enrolled in this study. Each patient underwent both chest CT scan and lung ultrasound examinations. Lung ultrasound was performed in 6 anatomical regions on each lung (anterior-superior, anteriorinferior, lateral-superior, lateral-inferior, posterior-superior, and posterior-inferior). Lung contusion was identified by observing localized pulmonary effusion along with disrupting the lung parenchyma. To evaluate the extent of lung damage, the ratio of partial pressure of oxygen in arterial blood to the fraction of inspired oxygen concentration (PaO2/FiO2 ratio) was utilized, while the extent of lung involvement was classified using the blunt pulmonary contusion score (BPC-18 score). Results: In this study, lung ultrasonography demonstrated a sensitivity of 93.6% for detecting lung contusions, with a specificity of 94.1%, positive predictive value (PPV) of 98.3%, negative predictive value (NPV) of 80%, and overall accuracy of 93.7%. Specifically, for the right lung, these measures were 90.9%, 96%, 98%, 82.7%, and 92.5%, respectively. For the left lung, the corresponding values were 88%, 96.6%, 97.7%, 82.8%, and 91.2%. The receiver operating characteristics (ROC) curve assessed the sensitivity and specificity of ultrasound in diagnosing lung contusions within the first 24 hr of ICU admission. The area under the curve (AUC) for this assessment was 0.939, indicating high diagnostic accuracy. Conclusion: While CT remains the standard for evaluating lung contusions, its accessibility may be limited due to various circumstances, especially during hemodynamic instability. In these situations, ultrasound is highly valuable in diagnosing lung contusions with exceptional sensitivity, specificity, and diagnostic accuracy. Chest ultrasound emerges as an essential, noninvasive, and safe diagnostic tool at the bedside in the ICU for detecting lung contusions. https://www.knepublishing.com/index.php/DMJ/article/view/17806lung contusionultrasoundCT scantrauma
spellingShingle Reza Alizadeh Kashani
Sevak Hatamian
Mohammad Reza Maghsoudi
Mahnaz Zoghi
Comparative Evaluation of Lung Contusion Assessment Using Ultrasound and Computed Tomography Scan in the First 24 Hours of Intensive Care Unit Admission
Dubai Medical Journal
lung contusion
ultrasound
CT scan
trauma
title Comparative Evaluation of Lung Contusion Assessment Using Ultrasound and Computed Tomography Scan in the First 24 Hours of Intensive Care Unit Admission
title_full Comparative Evaluation of Lung Contusion Assessment Using Ultrasound and Computed Tomography Scan in the First 24 Hours of Intensive Care Unit Admission
title_fullStr Comparative Evaluation of Lung Contusion Assessment Using Ultrasound and Computed Tomography Scan in the First 24 Hours of Intensive Care Unit Admission
title_full_unstemmed Comparative Evaluation of Lung Contusion Assessment Using Ultrasound and Computed Tomography Scan in the First 24 Hours of Intensive Care Unit Admission
title_short Comparative Evaluation of Lung Contusion Assessment Using Ultrasound and Computed Tomography Scan in the First 24 Hours of Intensive Care Unit Admission
title_sort comparative evaluation of lung contusion assessment using ultrasound and computed tomography scan in the first 24 hours of intensive care unit admission
topic lung contusion
ultrasound
CT scan
trauma
url https://www.knepublishing.com/index.php/DMJ/article/view/17806
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