الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Pleuropulmonary diseases such as pleural effusion and pneumonia are common and stressing challenges facing the clinicians at Intensive care units. Portable CXR is currently the initial imaging request in ICUs. However, obtaining diagnostic quality films are not always possible. There are various obstacles to gain interpretable CXR films. For instance, some critically ill patients are uncooperative resulting in motion artefacts and uncontrolled scattered radiation in obese patients. Multiple support lines and tubes may decrease the ability to move, position and centralize patients adequately.
Nowadays chest CT is the gold standard in the diagnosis of pleural effusion, pneumothorax, lung consolidation and alveolar interstitial syndrome. However, its use in ICU is still limited greatly by the need to transport critically ill patient which is risky and usually requires cardio-respiratory monitoring. Not to mention its cost, time consumption and effect of exposure to ionizing radiations.
The use of CUS is gaining rapid popularity for many reasons. On one hand, it offers unique merits such as smooth scan at the bedside, it is safe allowing repeated evaluations with fast and valuable diagnostic information. On the other hand, CUS is of major interest because current tools (CXR, CT) showed many drawbacks.
The aim of the current study was to determine the relative efficacy of chest ultrasonography in comparison to CXR for the detection of four common diseases (pneumothorax, pleural effusions, alveolar consolidation, and alveolar interstitial syndrome) using thoracic computed tomography (CT) as a gold standard.
Summary
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The study was conducted on 50 adult patients, who were admitted to Menofia University Hospital Intensive Care Unit (ICU).
All patients included in the study were subjected to complete history, physical examination, chest ultrasound as well as bedside AP-CXR followed by CT. Four major entities were evaluated by each imaging method: pleural effusion, consolidation, alveolar interstitial syndrome and pneumothorax.
Measurement of sensitivity, specificity and diagnostic accuracy for each method was calculated and then statistical analysis was done.
Our study documented that chest US is superior to CXR as a very useful bed side diagnostic tool providing immediate diagnosis of pleural effusion, consolidation, alveolar interstitial syndrome and pneumothorax compared to CT chest as the gold standard with overall accuracy of 94.29%, 94.83%, 95%, 98.87% respectively. Considering the unique properties of chest ultrasound versus the multiple impractical drawbacks of CT chest, current data support chest US as a reasonable substitution.
Conclusively, our study reported chest ultrasound is an effective, safe bed side diagnostic tool for pleuropulmonary diseases that offers a comparable accuracy to CT in ICU patients.