A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?
Yıl: 2015 Cilt: 21 Sayı: 5 Sayfa Aralığı: 344 - 351 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022
A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?
Öz: AMAÇ: Micropower impulse radar (MIR) teknolojisi ile çalışan Pneumoscan cihazının acil serviste pnömotoraks (PTX) tanısı koyabilmedeki etkinliğini değerlendirmeyi amaçladık. GEREÇ VE YÖNTEM: Pnömotoraks şüphesi bulunan ve toraks bilgisayarlı tomografisi (BT) endikasyonu olan hastalar çalışmaya dahil edildi. Toraks tomografisindeki bulgular ile Pneumoscan cihazının sonuçları karşılaştırıldı. Katagorik değişkenlerin kıyaslanmasında ki-kare ve Fisher kesin testi kullanıldı. BULGULAR: Çalışma grubunu oluşturan 115 hastanın toplam 12'sinde BT ile PTX tespit edildi. Pneumoscan'da 10 doğru pozitif sonuç, 36 doğru negatif sonuç, 67 yanlış pozitif sonuç, iki yanlış negatif sonuç vardı. Pneumoscan ile toraks BT'nin pnömotoraksı tespit edebilirliği arasında istatistiksel olarak anlamlı bir fark bulunmamıştır (p=0.33). Cihazın pnömotoraksı tespit etmedeki sensitivitesi %83.3, spesifitesi %35.0 olarak bulundu. Gö- ğüs tomografisinde görülen pnömotoraksın boyutu ile cihazımızın pnömotoraksı belirlemesi arasında anlamlı bir farklılık bulunamamıştır (p=0.470). Bilgisayarlı tomografide PTX'lerin sağ ya da sol hemitoraksta olması ile cihazın pnömotoraksı tespit etmesi arasında anlamlı bir farklılık bulunamamıştır (p=1.00). Pneumoscan'ın doğru pozitif olarak tespit ettiği 10 hastanın, tomografide ölçülen göğüs duvar kalınlığı ortalama 50.3 mm iken, yanlış negatif iki hastanın göğüs duvar kalınlığı ise 56.5 mm olarak bulunmuştur. Ancak göğüs duvar kalınlığı ile cihazın tanı koyması arasındaki ilişki istatistiksel olarak anlamlı değildi (p=0.766). Pneumoscan'ın yanlış pozitif olarak PTX var dediği 67 olgunun %46.3'ünde (n=31) BT'de bronşiektazi, konsolidasyon, sıvı ve kitle gibi PTX dışı bulguları vardı. Tomografide ek bulgu olup olmaması ile cihazın pnömotoraks tespit edip etmesi arasında anlamlı bir farklılık bulunamamıştır (p=0.472). TARTIŞMA: Çalışmamızla pnömotoraksı olan hastaları ayırt etme konusunda etkin olan Pneumoscan cihazının acil serviste kullanımı, yüksek yanlış pozitiflik oranından dolayı tartışmalı hale gelmiştir. Yanlış pozitif tanı oranındaki bu yükseklik bazı hastalara gereksiz chest tube takma girişimine neden olabilir. Ayrıca pnömotoraksın büyüklüğünü gösteremeyen Pneumoscan cihazı, geleneksel tanısal görüntüleme yöntemlerinin aksine verilecek tedaviyi ve prognozu belirlemede yardımcı olamamaktadır. Bulgular cihazın acil serviste kullanımının etkin olmadığını göstermiştir. İlerleyen yıllarda artan deneyim ve çalışmalar ile bu sonuç değişebilir.
Anahtar Kelime: Konular:
İleriye yönelik bir çalışma: Taşınabilir micropower impulse radar teknolojisi (Pneumoscan) pnömotoraks tanısında umut veren bir metot mudur?
Öz: BACKGROUND: This study aimed to discuss the effectiveness of Pneumoscan working with micropower impulse radar (MIR) technology in diagnosing pneumothorax (PTX) in the emergency department. METHODS: Patients with suspicion of PTX and indication for thorax tomography (CT) were included into the study. Findings of the Thorax CT were compared with the results of Pneumoscan. Chi-square and Fisher's exact tests were used in categorical variables.RESULTS: One hundred and fifteen patients were included into the study group; twelve patients presented with PTX diagnosed by CT, 10 of which were detected by Pneumoscan. Thirty-six true negative results, sixty-seven false positive results, and two false negative results were obtained, which resulted in an overall sensitivity of 83.3%, specificity of 35.0% for Pneumoscan. There was no statistically significant difference between the effectiveness of Pneumoscan and CT on the detection of PTX (p=0.33). There was no difference between the size of PTX diagnosed by CT and PTX diagnosed by Pneumoscan (p=0.47). There was no statistically significant difference between Pneumoscan and CT on detecting the localisation of the PTX (p=1.00). For the 10 cases diagnosed by Pneumoscan, mean chest wall thickness was determined as 50.3 mm while mean chest wall thickness for two false negatives diagnosed by Pneumoscan was 56.5 mm. However, no statistically significant difference was found between the chest wall thickness and the effectiveness of Pneumoscan on the detection of the PTX (p=0.77). Among sixty-seven false positives diagnosed by Pneumoscan, 46.3% had additional medical signs such as bronchiectasis, pulmonary consolidation, pulmonary edema or pulmonary tumor when they had a reading with CT. The relationship between having additional medical signs at the reading with CT and the effectiveness of Pneumoscan on the detection of the PTX was investigated and no significant difference was found (p=0.472).CONCLUSION: Using Pneumoscan to detect PTX is controversial since the device has a high false positive ratio. Wherein, false positive diagnosis can cause unjustifiable chest tube insertion. In addition, the device failed to show the size of the PTX, and therefore, it did not aid in determining the treatment and prognosis on contrary to traditional diagnostic methods. The findings could not demonstrate that the device was efficient in emergency care. Further studies and increasing experience may change this outcome in upcoming years.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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- van Berkel V, Kuo E, Meyers BF. Pneumothorax, bullous disease, and em- physema. Surg Clin North Am 2010;90:935-53.
- Lee KL, Graham CA, Yeung JH, Ahuja AT, Rainer TH. Occult pneumo- thorax in Chinese patients with significant blunt chest trauma: incidence and management. Injury 2010;41:492-4.
- Rivas de Andrés JJ, Jiménez López MF, Molins López-Rodó L, Pérez Trullén A, Torres Lanzas J; Spanish Society of Pulmonology and Tho- racic Surgery. Guidelines for the diagnosis and treatment of spontaneous pneumothorax. [Article in Spanish] Arch Bronconeumol 2008;44:437- 48. [Abstract]
- Cai W, Lee JG, Fikry K, Yoshida H, Novelline R, de Moya M. MDCT quantification is the dominant parameter in decision-making regarding chest tube drainage for stable patients with traumatic pneumothorax. Comput Med Imaging Graph 2012;36:375-86.
- Nandipati KC, Allamaneni S, Kakarla R, Wong A, Richards N, Satter- field J, et al. Extended focused assessment with sonography for trauma (EFAST) in the diagnosis of pneumothorax: experience at a community based level I trauma center. Injury 2011;42:511-4.
- Lomoschitz FM, Eisenhuber E, Linnau KF, Peloschek P, Schoder M, Bankier AA. Imaging of chest trauma: radiological patterns of injury and diagnostic algorithms. Eur J Radiol 2003;48:61-70.
- Zehtabchi S, Morley EJ, Sajed D, Greenberg O, Sinert R. Delayed pneu- mothorax after stab wound to thorax and upper abdomen: Truth or myth? Injury 2009;40:40-3.
- Holscher CM, Faulk LW, Moore EE, Cothren Burlew C, Moore HB, Stewart CL, et al. Chest computed tomography imaging for blunt pediat- ric trauma: not worth the radiation risk. J Surg Res 2013;184:352-7.
- Albers CE, Haefeli PC, Zimmermann H, de Moya M, Exadaktylos AK. Can handheld micropower impulse radar technology be used to detect pneumothorax? Initial experience in a European trauma centre. Injury 2013;44:650-4.
- Levy PD, Hile DC, Hile LM, Miller MA. A prospective analysis of the treatment of friction blisters with 2-octylcyanoacrylate. J Am Podiatr Med Assoc 2006;96:232-7.
- El Hammoumi MM, Drissi G, Achir A, Benchekroun A, Benosman A, Kabiri EH. Iatrogenic pneumothorax: experience of a Moroccan Emer- gency Center. Rev Port Pneumol 2013;19:65-9.
- Levy PD, Wielinski T, Greszler A. Micropower impulse radar: a novel technology for rapid, real-time detection of pneumothorax. Emerg Med Int 2011;2011:279508.
- Azevedo S, McEwan TE. Micropower impulse radar: a new pocket-sized radar that operates up to peveral years on AA batteries. IEEE Potentials 1997;16:15-20.
- MacDuff A, Arnold A, Harvey J; BTS Pleural Disease Guideline Group. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010;65 Suppl 2:18-31.
- Exadaktylos AK, de Moya MA, Lecky F, Driscoll P, Zimmermann H, Wallis LA, et al. Imaging and resuscitation in trauma. Emerg Med Int 2011;2011:313404.
- van der Wilden GM, Albers CE, Haefeli PC, Zimmermann H, Exada- ktylos A, Levy P, et al. Using micropower impulse radar technology to screen for pneumothorax: an international bi-institutional study. J Trau- ma Acute Care Surg 2012;73:1418-20.
- Hameed SM, Kortbeek JB. Chest injuries. Current Orthopaedics 2003;17:260-73.
- Costantino M, Gosselin MV, Primack SL. The ABC's of thoracic trauma imaging. Semin Roentgenol 2006;41:209-25.
- Johnson NN, Toledo A, Endom EE. Pneumothorax, pneumomediasti- num, and pulmonary embolism. Pediatr Clin North Am 2010;57:1357- 83.
| APA | Hocagil H, HOCAGİL A, KARACABEY S, AKKAYA T, ŞİMŞEK G, SANRI E (2015). A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?. , 344 - 351. |
| Chicago | Hocagil Hilal,HOCAGİL Abdullah Cüneyt,KARACABEY SİNAN,AKKAYA Tuğba,ŞİMŞEK Gözde,SANRI Erkman A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?. (2015): 344 - 351. |
| MLA | Hocagil Hilal,HOCAGİL Abdullah Cüneyt,KARACABEY SİNAN,AKKAYA Tuğba,ŞİMŞEK Gözde,SANRI Erkman A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?. , 2015, ss.344 - 351. |
| AMA | Hocagil H,HOCAGİL A,KARACABEY S,AKKAYA T,ŞİMŞEK G,SANRI E A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?. . 2015; 344 - 351. |
| Vancouver | Hocagil H,HOCAGİL A,KARACABEY S,AKKAYA T,ŞİMŞEK G,SANRI E A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?. . 2015; 344 - 351. |
| IEEE | Hocagil H,HOCAGİL A,KARACABEY S,AKKAYA T,ŞİMŞEK G,SANRI E "A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?." , ss.344 - 351, 2015. |
| ISNAD | Hocagil, Hilal vd. "A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?". (2015), 344-351. |
| APA | Hocagil H, HOCAGİL A, KARACABEY S, AKKAYA T, ŞİMŞEK G, SANRI E (2015). A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?. Ulusal Travma ve Acil Cerrahi Dergisi, 21(5), 344 - 351. |
| Chicago | Hocagil Hilal,HOCAGİL Abdullah Cüneyt,KARACABEY SİNAN,AKKAYA Tuğba,ŞİMŞEK Gözde,SANRI Erkman A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?. Ulusal Travma ve Acil Cerrahi Dergisi 21, no.5 (2015): 344 - 351. |
| MLA | Hocagil Hilal,HOCAGİL Abdullah Cüneyt,KARACABEY SİNAN,AKKAYA Tuğba,ŞİMŞEK Gözde,SANRI Erkman A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?. Ulusal Travma ve Acil Cerrahi Dergisi, vol.21, no.5, 2015, ss.344 - 351. |
| AMA | Hocagil H,HOCAGİL A,KARACABEY S,AKKAYA T,ŞİMŞEK G,SANRI E A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?. Ulusal Travma ve Acil Cerrahi Dergisi. 2015; 21(5): 344 - 351. |
| Vancouver | Hocagil H,HOCAGİL A,KARACABEY S,AKKAYA T,ŞİMŞEK G,SANRI E A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?. Ulusal Travma ve Acil Cerrahi Dergisi. 2015; 21(5): 344 - 351. |
| IEEE | Hocagil H,HOCAGİL A,KARACABEY S,AKKAYA T,ŞİMŞEK G,SANRI E "A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?." Ulusal Travma ve Acil Cerrahi Dergisi, 21, ss.344 - 351, 2015. |
| ISNAD | Hocagil, Hilal vd. "A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?". Ulusal Travma ve Acil Cerrahi Dergisi 21/5 (2015), 344-351. |
