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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(02): 162-172
DOI: 10.1055/s-0042-1759850
Original Article

Lung Ultrasound: A Complementary Imaging Tool for Chest X-Ray in the Evaluation of Dyspnea

Aparna Murali 
1   Department of Radiodiagnosis, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi, India
,
Anjali Prakash
1   Department of Radiodiagnosis, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi, India
,
Rashmi Dixit
1   Department of Radiodiagnosis, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi, India
,
Monica Juneja
2   Department of Pediatrics, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi, India
,
Naresh Kumar
3   Department of Pulmonary Medicine, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi, India
,
Prerna Padaliya
1   Department of Radiodiagnosis, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi, India
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Abstract

The present study was designed to evaluate the spectrum of imaging findings seen on chest ultrasonography in patients presenting with dyspnea and verify the concordance between chest X-ray and chest ultrasound.

Methods Fifty-three patients presenting with dyspnea were included in this study. Patients with known/suspected cardiac disease were excluded from the study. All patients underwent chest X-ray and chest ultrasound, reported by two different investigators. The concordance was analyzed using Cohen's kappa value with a ‘p-value’ less than 0.05 considered statistically significant.

Results Among the fifty-three patients with dyspnea, five diagnostic pathologies were evaluated. Concordance between lung ultrasound and chest X-ray for diagnosis of pneumonia, pneumothorax, acute exacerbation of COPD/severe asthma, and diffuse alveolar interstitial syndrome was found to be high with Cohen's kappa value > 0.8 (p < 0.01). Ultrasound was able to correctly diagnose more cases of pneumothorax and pulmonary edema compared with chest X-ray with sensitivity and negative predictive value of 100%. Chest X-ray was found to be superior in correctly diagnosing COPD. The difference was, however, not statistically significant. Similarly, no statistically significant difference could be inferred between the diagnostic value of ultrasound and Chest X-ray in the diagnosis of pneumonia or pleural effusion.

Conclusions A high concordance was noted between ultrasound and chest X-ray for diagnosis of all pathologies studied (p < 0.01), the highest noted in pneumonia/pleural effusion and diffuse interstitial syndrome (κ = 0.9). Hence, ultrasound may be considered a complimentary imaging modality for Chest-X-ray in the evaluation of dyspnea.

Keywords

A-lines - B-lines - dyspnea - lung ultrasound


Publikationsverlauf

Artikel online veröffentlicht:
06. Januar 2023

© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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