Lung ultrasound bests X ray for diagnosing neonatal pneumothorax: Study
China: Lung ultrasound (LUS) has better sensitivity and specificity than chest X-ray and also took less time to perform for the diagnosis of pneumothorax in neonates, suggests a recent review in the journal Ultrasound in Medicine and Biology.
Neonatal pneumothorax is common and a life-threatening condition. Chest X-ray is the main diagnostic method but is limited by some defects. Newborns are especially at risk for latent effects from repeated exposure to ionizing radiation, and it can be difficult to detect pneumothorax with chest x-ray. In recent years, lung ultrasound has emerged as a diagnostic method. The aim of the review by Qiang Fei, National Clinical Research Center for Child Health, Hangzhou, China, and colleagues is to compare the diagnostic accuracy of lung ultrasound versus chest X-ray in neonates with pneumothorax.
For the purpose, the researchers searched both Chinese- and English-language databases for prospective studies on the diagnostic accuracy of lung ultrasound in neonates with pneumothorax. The search yielded 528 studies, of which 8 full texts were assessed for eligibility against the inclusion/exclusion criteria.
Key findings of the study include:
- The overall specificity and sensitivity of lung ultrasound in the diagnosis of neonatal pneumothorax was 98% and 99% respectively.
- The diagnostic odds ratio was 920.01, and the area under the curve was 0.996 7
- The chest X-ray was always taken as the reference standard with a sensitivity of 82%, a specificity of 96% and a diagnostic odds ratio of 44.54.
- Study analysis studies indicated that the sensitivity of lung ultrasound in diagnosing pneumothorax excepted chest X-ray as the single diagnosis criteria was 98%, the specificity was 100% and the diagnostic odds ratio was 965.39, showing a higher accuracy than chest X-ray.
"In conclusion, lung ultrasound had better sensitivity and specificity than chest X-ray in the diagnosis of pneumothorax," wrote the authors. "Some ultrasonic signs (absence of lung sliding or B-lines) had a high sensitivity in the diagnosis, which could be used to diagnose pneumothorax. Lung point could help judge the severity of pneumothorax. Its presence indicates that pneumothorax is mild to moderate; otherwise, pneumothorax is severe.
"Lung Ultrasound, a Better Choice for Neonatal Pneumothorax: A Systematic Review and Meta-analysis," is published in the journal Ultrasound in Medicine and Biology.
DOI: https://www.umbjournal.org/article/S0301-5629(20)30519-6/fulltext
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