Rune Wiig, Casper Falster, Niels Jacobsen, Stefan Posth, August Emil Licht, Christian Laursen
{"title":"肺超声弹性成像预测急诊科胸腔积液恶性来源的准确性","authors":"Rune Wiig, Casper Falster, Niels Jacobsen, Stefan Posth, August Emil Licht, Christian Laursen","doi":"10.1183/13993003.congress-2023.pa1824","DOIUrl":null,"url":null,"abstract":"<b>Aims:</b> Ultrasound is a valuable diagnostic tool in the diagnostic work-up of dyspnea and can identify even small pleural effusions. Incorporating Shear Wave Elastography (SWE) represents a possible tool in stratifying pleural effusions by risk of underlying malignancy. No previous studies have been conducted in an emergency department (ED), where it might have a clinical impact by hastening referral for diagnostic work-up of underlying malignancy. The aim of this study was to appraise the diagnostic accuracy of ultrasonographic findings associated with thoracic malignancy, as well as calculating optimal cut-off values for SWE in this regard. <b>Methods:</b> Patients with unilateral pleural effusion of unknown origin were included in the ED and subjected to a Focused Lung Ultrasound (FLUS) scan during their first 48 hours after admittance. Two index tests were applied: i) traditional 2D FLUS examination registering presence of diaphragmatic noduli, pleural thickenings and other findings associated with malignancy, and ii) a SWE examination of different Regions of Interest. Reference test was defined as subsequent diagnosis of malignant pleural effusion (MPE) in the three months following inclusion. <b>Results:</b> 39 patients were included. The 2D index test yielded a sensitivity of 28.57% (95%CI 3.67-70.96%) and a specificity of 90.62% (95%CI 74.98%-98.02%). The SWE max of intercostal space yielded a sensitivity of 100% (95%CI 47.82-100%) and a specificity of 59.09% (95%CI 36.35%-79.29%). <b>Conclusion:</b> FLUS with integrated SWE may aid in identifying MPE9s and improving referral to diagnostic work-up of underlying malignancy. Larger adequately powered studies are warranted.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"11 1","pages":"0"},"PeriodicalIF":0.8000,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnostic accuracy of lung ultrasound with elastography in predicting malignant origin of pleural effusions in an emergency department\",\"authors\":\"Rune Wiig, Casper Falster, Niels Jacobsen, Stefan Posth, August Emil Licht, Christian Laursen\",\"doi\":\"10.1183/13993003.congress-2023.pa1824\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<b>Aims:</b> Ultrasound is a valuable diagnostic tool in the diagnostic work-up of dyspnea and can identify even small pleural effusions. Incorporating Shear Wave Elastography (SWE) represents a possible tool in stratifying pleural effusions by risk of underlying malignancy. No previous studies have been conducted in an emergency department (ED), where it might have a clinical impact by hastening referral for diagnostic work-up of underlying malignancy. The aim of this study was to appraise the diagnostic accuracy of ultrasonographic findings associated with thoracic malignancy, as well as calculating optimal cut-off values for SWE in this regard. <b>Methods:</b> Patients with unilateral pleural effusion of unknown origin were included in the ED and subjected to a Focused Lung Ultrasound (FLUS) scan during their first 48 hours after admittance. Two index tests were applied: i) traditional 2D FLUS examination registering presence of diaphragmatic noduli, pleural thickenings and other findings associated with malignancy, and ii) a SWE examination of different Regions of Interest. Reference test was defined as subsequent diagnosis of malignant pleural effusion (MPE) in the three months following inclusion. <b>Results:</b> 39 patients were included. The 2D index test yielded a sensitivity of 28.57% (95%CI 3.67-70.96%) and a specificity of 90.62% (95%CI 74.98%-98.02%). The SWE max of intercostal space yielded a sensitivity of 100% (95%CI 47.82-100%) and a specificity of 59.09% (95%CI 36.35%-79.29%). <b>Conclusion:</b> FLUS with integrated SWE may aid in identifying MPE9s and improving referral to diagnostic work-up of underlying malignancy. Larger adequately powered studies are warranted.\",\"PeriodicalId\":23440,\"journal\":{\"name\":\"Ultrasound\",\"volume\":\"11 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2023-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ultrasound\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1183/13993003.congress-2023.pa1824\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ultrasound","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1183/13993003.congress-2023.pa1824","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Diagnostic accuracy of lung ultrasound with elastography in predicting malignant origin of pleural effusions in an emergency department
Aims: Ultrasound is a valuable diagnostic tool in the diagnostic work-up of dyspnea and can identify even small pleural effusions. Incorporating Shear Wave Elastography (SWE) represents a possible tool in stratifying pleural effusions by risk of underlying malignancy. No previous studies have been conducted in an emergency department (ED), where it might have a clinical impact by hastening referral for diagnostic work-up of underlying malignancy. The aim of this study was to appraise the diagnostic accuracy of ultrasonographic findings associated with thoracic malignancy, as well as calculating optimal cut-off values for SWE in this regard. Methods: Patients with unilateral pleural effusion of unknown origin were included in the ED and subjected to a Focused Lung Ultrasound (FLUS) scan during their first 48 hours after admittance. Two index tests were applied: i) traditional 2D FLUS examination registering presence of diaphragmatic noduli, pleural thickenings and other findings associated with malignancy, and ii) a SWE examination of different Regions of Interest. Reference test was defined as subsequent diagnosis of malignant pleural effusion (MPE) in the three months following inclusion. Results: 39 patients were included. The 2D index test yielded a sensitivity of 28.57% (95%CI 3.67-70.96%) and a specificity of 90.62% (95%CI 74.98%-98.02%). The SWE max of intercostal space yielded a sensitivity of 100% (95%CI 47.82-100%) and a specificity of 59.09% (95%CI 36.35%-79.29%). Conclusion: FLUS with integrated SWE may aid in identifying MPE9s and improving referral to diagnostic work-up of underlying malignancy. Larger adequately powered studies are warranted.
UltrasoundRADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.70
自引率
0.00%
发文量
55
期刊介绍:
Ultrasound is the official journal of the British Medical Ultrasound Society (BMUS), a multidisciplinary, charitable society comprising radiologists, obstetricians, sonographers, physicists and veterinarians amongst others.