Diagnosis of pleural effusion in intensive care patients with supine digital thoracic imaging. A study of CT validated cases

Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
C SchäferW Riedl

Abstract

The significance of the recumbent chest x-ray using digital luminescence radiography was to be assessed in respect of diagnosis of pleural effusions. Three experienced radiologists evaluated 32 digital recumbent chest x-rays of 32 intensive-care patients. The radiologists were asked to estimate the effusion volume and to assess whether typical x-ray signs of pleural effusions were seen. These evaluations were compared with one another and with the simultaneously produced CTs. Diagnostic accuracy of the digital recumbent chest x-ray is of medium quality in respect of diagnosis of pleural effusions (sensitivity: 69%, specificity: 54%, positive predictive value: 81%, negative predictive value: 34%, rate of accuracy: 65%). Diagnostic safety is the same for right-sided or left-sided pleural effusions, and increases with increasing effusion volume. The ratings by the radiologists are statistically not significantly different, but are significantly different from the CT measurements (Wilcoxon test, p < 0.05). Correlations of the assessments and the measurements were weakly positive (r = 0.24, r = 0.36, r = 0.47). The pleural effusions were on the average underestimated by the radiologists. The median predictive error was 203 ml. Recum...Continue Reading

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