What are limitations of ultrasound in the evaluation of pneumothorax?

Updated: Apr 28, 2020
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Answer

Ultrasonography is heavily operator dependent. In addition, this modality cannot be used to discriminate between a chronic obstructive pulmonary disease (COPD)-associated bleb and pneumothorax. [53]

The sensitivity ultrasonography drops in the ICU, especially in patients with acute respiratory distress syndrome (ARDS), [54] Moreover, in a preliminary study by Dente et al, although ultrasonographic evaluation for pneumothorax was found to be very accurate for the first 24 hours after insertion of a thoracostomy tube, its accuracy was not sustained over time. [45] Twenty-four hours after thoracostomy, diagnostic sensitivity of ultrasonography for pneumothorax fell to 55%, and its positive predictive value to 43%. This may be related to intrapleural adhesion formation. [45]

Go to Radiologic Diagnosis of Pneumothorax for complete information on this topic.


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