Comparison of A-mode ultrasound and computed tomography: detection of secretion in maxillary and frontal sinuses in ventilated patients.
OBJECTIVE
To study the accuracy of A-mode ultrasonography (A-MU) in detecting secretion in maxillary and frontal sinuses in critically ill, intubated patients undergoing mechanical ventilation.


METHODS
Open study in mechanically ventilated, comatose patients.


METHODS
Medical-surgical intensive care unit in the General Hospital of Rovigo.


METHODS
50 consecutive, mechanically ventilated, critically ill patients. All patients were in a coma and needed cerebral computed tomography (CT) for a diagnosis.


RESULTS
The A-MU technique gave 100 images of maxillary and frontal sinuses. The images were read blindly and classified into five categories: definitely normal, definitely abnormal, probably normal, questionable, and probably abnormal. CT findings were considered to be the "gold standard". The specificity of echo images varied from 72 to 98% and the sensitivity from 63 to 86% for maxillary sinuses. For frontal sinuses, the specificity varied from 96 to 99% and the sensitivity from 14 to 57%. The area under the receiver-operating characteristic curve was found to be 0.89 and 0.76 for maxillary and frontal sinuses, respectively.


CONCLUSIONS
The A-MU technique is an accurate tool for detecting secretion in the maxillary sinuses in intubated patients. More investigations are necessary in order to evaluate its usefulness in the frontal sinuses.
Lucchin
F
F
Servizio di Anestesia e Rianimazione, Ospedale Civile di Rovigo, Italy.
Minicuci
N
N
Ravasi
M A
MA
Cordella
L
L
Palù
M
M
Cetoli
M
M
Borin
P
P
D000328:Adult; D000368:Aged; D003128:Coma / Q000150:complications / Q000628:therapy*; D003428:Cross Infection / Q000000981:diagnostic imaging* / Q000209:etiology; D015522:Frontal Sinusitis / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D015523:Maxillary Sinusitis / Q000000981:diagnostic imaging* / Q000209:etiology; D008875:Middle Aged; D009093:Mucus / Q000000981:diagnostic imaging; D012372:ROC Curve; D012121:Respiration, Artificial / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography