A Comparative Analysis of Thoracic Ultrasound with Radiography in the Detection of Lung Pathologies among Patients in Intensive Care Units

Abstract

Introduction: Chest X‑ray (CXR) is a common study in intensive care unit (ICU) and to a lesser extent, chest computed tomography. Both studies use ionizing radiation. Bedside ultrasound (US) avoids exposure to ionizing radiation or potentially hazardous movement of the patient. Materials and Methods: This was a prospective, cross‑sectional, comparative study of B‑mode thoracic ultrasound (TUS) with CXR in the detection of lung pathologies in ICU patients. M‑mode was further used in suspected pneumothorax (PTX). Patients with clinical suspicion or diagnosis of lung pathologies were recruited. CXR with portable machine and TUS using mobile US machine were done. Results: Seventy patients were recruited; 38 (54.3%) were female. Pleural effusion was detected in 17 patients, 15 (88.2%) by TUS and 11 (64.7%) by CXR. TUS and CXR detected lung consolidations in 11 (84.6%) and 9 (69.2%) patients, respectively. PTX was seen by CXR in 6 (85.7%) patients and 5 (71.4%) were seen on TUS. Both modalities diagnosed equal numbers of alveolar and interstitial edemas. Conclusion: Overall, there was no statistically significant difference in imaging diagnosis of lung pathologies by TUS and CXR. However, TUS detected more pleural effusion and consolidations; hence, it may be considered an alternative in the management of pediatric patients and pregnant women to avoid ionizing radiation.