title: Lung ultrasound in critically ill patients: comparison with bedside chest radiography.
abstract: OBJECTIVE
  To compare the diagnostic performance of lung ultrasound and bedside chest radiography (CXR) for the detection of various pathologic abnormalities in unselected critically ill patients, using thoracic computed tomography (CT) as a gold standard.
  
  
  METHODS
  Forty-two mechanically ventilated patients scheduled for CT were prospectively studied with a modified lung ultrasound protocol. Four pathologic entities were evaluated: consolidation, interstitial syndrome, pneumothorax, and pleural effusion. Each hemithorax was evaluated for the presence or absence of each abnormality.
  
  
  RESULTS
  Eighty-four hemithoraces were evaluated by the three imaging techniques. The sensitivity, specificity, and diagnostic accuracy of CXR were 38, 89, and 49% for consolidation, 46, 80, and 58% for interstitial syndrome, 0, 99, and 89% for pneumothorax, and 65, 81, and 69% for pleural effusion, respectively. The corresponding values for lung ultrasound were 100, 78, and 95% for consolidation, 94, 93, and 94% for interstitial syndrome, 75, 93, and 92% for pneumothorax, and 100, 100, and 100% for pleural effusion, respectively. The relatively low sensitivity of lung ultrasound for pneumothorax could be due to small number of cases (n = 8) and/or suboptimal methodology.
  
  
  CONCLUSIONS
  In our unselected general ICU population lung ultrasound has a considerably better diagnostic performance than CXR for the diagnosis of common pathologic conditions and may be used as an alternative to thoracic CT.
authors.affiliation: Department of Intensive Care Medicine, University Hospital of Heraklion, University of Crete, Heraklion, Crete, Greece.
authors.forename: Nektaria
authors.initials: N
authors.lastname: Xirouchaki
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Magkanas
authors.forename: Katerina
authors.initials: K
authors.lastname: Vaporidi
authors.forename: Eumorfia
authors.initials: E
authors.lastname: Kondili
authors.forename: Maria
authors.initials: M
authors.lastname: Plataki
authors.forename: Alexandros
authors.initials: A
authors.lastname: Patrianakos
authors.forename: Evaggelia
authors.initials: E
authors.lastname: Akoumianaki
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Georgopoulos
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008168:Lung / Q000000981:diagnostic imaging*; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion; D011030:Pneumothorax; D019095:Point-of-Care Systems; D011446:Prospective Studies; D013902:Radiography, Thoracic; D014463:Ultrasonography