Lung parenchymal injury and its frequency in blunt thoracic trauma: the diagnostic value of chest radiography and thoracic CT.
OBJECTIVE
The aims of this study were to determine the value of chest radiography in diagnosing lung parenchymal injury in patients with thoracic trauma, and to evaluate the frequency of lung parenchymal injury by using thoracic computed tomography (CT).


METHODS
Between January 2005 and June 2006, we retrospectively evaluated the anteroposterior chest radiographs and thoracic CTs of 60 patients that presented to our emergency department and were hospitalized due to multi-organ trauma.


RESULTS
Chest radiography revealed parenchymal injury in 32 of the patients, while thoracic CT confirmed parenchymal injury in only 27 of these 32 patients. Chest radiographs did not reveal any parenchymal injury in 28 of the patients, whereas thoracic CT detected parenchymal injury in 12 of these 28 patients. Thoracic CT results were accepted as the gold standard in the evaluation of patients with chest trauma and showed that the sensitivity, specificity, positive predictive value, and negative predictive value of chest radiography in determining parenchymal injury were 69%, 76%, 84%, and 57%, respectively. In addition, thoracic CT revealed that 65% of the patients with blunt thoracic trauma suffered parenchymal injury.


CONCLUSIONS
The sensitivity of anteroposterior chest radiography in identifying lung parenchymal injury was low, with a high false negative rate; therefore, we think that early evaluation with thoracic CT is extremely helpful in the diagnosis and treatment of patients with thoracic trauma, adding to the cooperative work that exists between radiologists and emergency physicians.
Elmali
Muzaffer
M
Department of Radiology, 19 Mayis University School of Medicine, Samsun, Turkey. muzafel@yahoo.com
Baydin
Ahmet
A
Nural
Mehmet Selim
MS
Arslan
Bora
B
Ceyhan
Meltem
M
Gürmen
Nevzat
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011237:Predictive Value of Tests; D013902:Radiography, Thoracic / Q000379:methods / Q000706:statistics & numerical data*; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013898:Thoracic Injuries / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000706:statistics & numerical data*; D014421:Turkey