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Ultrasound Viable Option to Radiography in Acute Dyspnea

Ultrasonography, radiography show high concordance for most diseases causing dyspnea

FRIDAY, May 6 (HealthDay News) -- For most pulmonary diseases causing dyspnea, ultrasonography and radiography demonstrate high concordance, but ultrasound is more accurate at identifying free pleural effusion, according to a study published in the May issue of Chest.

Maurizio Zanobetti, M.D., from the University of Florence in Italy, and colleagues examined the concordance between chest ultrasonography and radiography in 404 patients with dyspnea presenting to emergency departments during a single emergency physician shift. Chest computed tomography (CT) scanning was used to confirm diagnosis in 118 patients who had mismatch between the ultrasonography and radiography. Concordance was measured using the Cohen κ test. Patients with trauma presenting with dyspnea were excluded from the study.

The investigators found that, in most pulmonary diseases, ultrasonography and radiography exhibited high concordance, especially in pulmonary edema (κ = 95 percent). The concordance was similar for both left and right sides of the lungs for lung abnormalities, including free pleural effusion, loculated pleural effusion, pneumothorax, and lung consolidation. In cases of discordant results, CT scans confirmed ultrasound findings in 63 percent of patients. Ultrasonography displayed significantly higher sensitivity in patients with free pleural effusion compared to radiography.

"Our study demonstrated high concordance between chest ultrasonograph and standard radiograph in most pulmonary diseases causing dyspnea," the authors write.

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