Comparative Study between Chest Radiography and Ultrasound Findings in ICU Patients with Respiratory Distress

Abstract Background Lung radiology is regularly done for the patients in intensive care units. Chest x-ray is considered one of the most easy imaging modalities. However, it may be not comfortable for critical patients in addition to the hazards of irradiation. The high variability of quality of the chest x-ray image makes its interpretation difficult. Nowadays bedside lung ultrasound is increasingly used in patients managed in intensive care units (ICUs) Objective To compare the diagnostic performance of lung ultrasound and bedside chest radiography for the detection of various pathologic abnormalities in unselected critically ill patients. Patients and Methods A prospective study done on 60 patients with respiratory distress admitted to the intensive care unit at our institute over 7 months. Chest X-ray and lung ultrasound were done to all the patients and then compared regarding the clinical diagnosis of pulmonary diseases and further radiological and laboratory methods. Results One Hundred Twenty hemithoraces were evaluated. The sensitivity, specificity, and diagnostic accuracy of CXR were 79.2, 94.4 and 88.3% for consolidation, 80, 100 and 98 % for pneumothorax, and 62.8, 96, and 76.7% for pleural effusion, respectively. The corresponding values for lung ultrasound were 87.5, 97, and 93.3% for consolidation, 100, 100, and 100 % for pneumothorax, and 91.4, 100, and 93.3% for pleural effusion, respectively. Conclusion Ultrasound is a bed side tool useful for rapid and early diagnosis of acute dyspnea in critical ill patients. It has higher sensitivity and higher specificity of diagnosis of chest diseases as pneumonia, pleural diseases and pneumothorax in comparison to CXR