Diagnostic Accuracy of Transthoracic Ultrasound of Lung In The Diagnosis Of Pulmonary Thromboembolism Taking Computed Tomography Pulmonary Angiography As Gold Standard

Abstract

Background: Pulmonary thromboembolism requires an immediate diagnosis since quick and efficient treatment can lower the chance of death. The best technique for making the diagnosis is thought to be CT pulmonary angiography. The use of transthoracic ultrasonography to diagnose medical conditions is on the rise. It is becoming more and more important for figuring out what is wrong with the chest and lungs. Transthoracic ultrasonography is becoming more and more important, however as far as we know, it is not routinely used or assessed in our region when trying to diagnose pulmonary thromboembolism.

Objective: To evaluate the performance of CT, pulmonary angiography, and transthoracic ultrasound to detect pulmonary thromboembolism in emergency situations (gold standard technique).

Study Design: It was a Diagnostic Accuracy Study.

Study Setting: The study was conducted at department of Diagnostic Radiology, Ch. Pervaiz Elahi Institute of Cardiology, Multan.

Methodology

224 people who were transported to the emergency room of the Ch. Pervaiz Elahi Institute of Cardiology were included in the cross-sectional study. Sequential, non-random sampling techniques were used. The sonographic examination of the chest took place with the patient either sitting or lying down. We looked at the upper and lower chest. Pulmonary thromboembolism was looked at if there are at least one or more distinct pleural-based or subpleural hypoechoic lesions, with or without pleural effusion. Moreover, there won't be any "vascular indication" of blood flow obstruction in a thromboembolic conduit. A proforma was used for data collection, and SPSS version 24.0 was used for statistical analysis.

Results

It was reported that the mean age of all the patients was 39.42± 13.15 years. There were 99 (44.2%) were male and 125 (55.8%) were females. The results demonstrate that TUS correctly spotted four out of five cases of pulmonary embolism, leading to an 80.9% sensitivity. It was 85.1% specific which means it is good at ruling out disease in those who are not affected. A positive TUS was most likely to be correct (with a PPV of 84.0%) and a negative TUS had a high probability of not showing disease (an NPV of 82.2%).

Conclusion

Thoracic ultrasound demonstrated adequate sensitivity and specificity, so it is a useful initial step for diagnosing pulmonary embolism. Although it should not replace CTPA, it helps in diagnosing heart disease where CTPA is unavailable.