Quantification analysis of pleural line movement for the diagnosis of pneumothorax

Rui Xiao; Qiang Shao; Ning Zhao; Fen Liu; Ke-Jian Qian

doi:10.12998/wjcc.v9.i21.5889

Quantification analysis of pleural line movement for the diagnosis of pneumothorax

World J Clin Cases. 2021 Jul 26;9(21):5889-5899. doi: 10.12998/wjcc.v9.i21.5889.

Authors

Rui Xiao¹, Qiang Shao¹, Ning Zhao¹, Fen Liu¹, Ke-Jian Qian²

Affiliations

¹ Department of Intensive Care Medicine, First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
² Department of Intensive Care Medicine, First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China. ndyfyicu@email.ncu.edu.cn.

Abstract

Background: There is no research on quantitative pleural line movement. In this study, we assume that tissue Doppler and its quantitative technology can quantify the pleural line movement and can be used to diagnose pneumothorax.

Aim: To evaluate the quantitative assessment of pleural line movement measured by tissue Doppler imaging (TDI) for pneumothorax diagnosis.

Methods: Adult patients (n = 45) diagnosed with unilateral pneumothorax were included in this study. Each patient underwent TDI of both lungs. The pneumothorax side and contralateral normal lung side were compared using several indices obtained from TDI: peak pleural line velocity (PVmax), peak chest wall tissue velocity (CVmax), peak pleural line strain value (PS_max), peak chest wall tissue strain value (CS_max), PV_max/CV_max and PS_max/CS_max. The receiver operating characteristic analysis was used to evaluate the performance of these quantitative assessments for pneumothorax diagnosis.

Results: Various quantitative variables of the pneumothorax side were all lower than that of the non-pneumothorax side and included the PV_max (0.36 cm/s vs 0.59 cm/s, P < 0.001), PS_max (1.14% vs 1.90%, P = 0.001), PV_max/CV_max (1.06 vs 4.93, P < 0.001), and PS_max/CS_max (0.76 vs 1.74, P < 0.001). For the discrimination of pneumothorax, the cut-off values of the PV_max, PS_max, PV_max/CV_max, and PS_max/CS_max were calculated as 0.50 cm/s, 0.94%, 1.96, and 1.12, respectively. Similarly, the sensitivities and specificities of PV_max, PS_max, PV_max/CV_max, and PS_max/CS_max were 96% and 62%, 47% and 91%, 93% and 96%, and 82% and 93%, respectively. The area under the receiver operating characteristic curve were 0.84, 0.72, 0.99, and 0.91, respectively, for PV_max, PS_max, PV_max/CV_max, and PS_max/CS_max.

Conclusion: Quantification analysis of pleural line movement using TDI is a useful tool for the diagnosis of pneumothorax.

Keywords: Lung ultrasound; Pleural line movement; Pneumothorax; Tissue Doppler imaging.