Ultrasound evaluation of spontaneous pneumothorax severity

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  • 超音波検査による自然気胸の重症度判定の試み

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Ultrasound diagnosis and severity assessment of pneumothorax were performed for 20 cases of spontaneous pneumothorax, with a collapse rate of 15% or more on chest radiograph, presenting at our hospital between October 2008 and March 2009. The severity was assessed by ultrasound observation of the lung sliding sign (LSS) at four points along the anterior and lateral chest wall (2nd intercostal space at the midclavicular line, 4th intercostal space at the anterior axillary line, and 6th intercostal spaces at the midaxillary and posterior axillary lines). Ultrasound observations were compared with the degree of collapse noted on chest radiograph. LSS was absent in all cases studied at the 2nd intercostal space, confirming the diagnosis of pneumothorax. In cases showing 16-40% collapse, LSS was present at some of the measurement points on the axilla. However, LSS was absent at every point of the axillary line in cases with a greater than 40% collapse, with only one exception. Ultrasound observations were consistent with radiographic findings. Our results indicate that ultrasonography may be useful for the diagnosis of pneumothorax as well as evaluation of the severity.

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