الفهرس 
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Abstract
Thoracic Ultrasonography is a low cost, noninvasive, practical, and rapid
method for visualization of different chest pathology. There is a growing body of
evidence about the high diagnostic accuracy of thoracic US in the diagnosis of
chest diseases and in guiding related interventions. Thoracic US exhibited high
sensitivity and specificity in the previous studies assessed its accuracy in the
diagnosis in different chest disorders.
This prospective study was carried out on 150 patients referred to us with
acute dysnea at Chest Department, Faculty of Medicine, Menoufia University
Hospitals from June 2018 to December 2019.
The patients were categorized according to their respiratory disorders as:
1. Patients with pleural diseases, airway disease, pneumonia and ILD, included
165 patients.
2. Patients with pulmonary embolism, pneumothorax, lung collapse and ARDS,
included 17 patients.
3. Patients with lung mass, lung cavity, pericardial effusion, bronchiectasis and
atrial mass, included 33 patients.
After written consents, all patients submitted to full history taking, clinical
examination, laboratory investigation, ABGs, CXR, CT and TUS examination.
Thoracic US chest examination was done by Philips Affiniti 50G machine
using grayscale (B-mode), or time-motion mode (M-mode). The patient was
positioned in a semi-recumbent position.
After application of ultrasound gel the selected probe was positioned on
the chest wall perpendicular to the skin with the index marker (dot or grove)
always pointing at the patient‟s head. The image marker on the screen
corresponded to the index marker on the probe and was positioned to the right of
the screen when cardiology convention was used and on the left with radiology
convention. Radiology convention was used. Gain and depth were adjusted to
obtain clear distinction of shades of grey and to cover the whole lung depth.
Anterior and posterior axillary lines divided the chest wall into three fields:
Anterior, Lateral and Posterior. The fields were further divided into equal
quadrants for a total of six areas on each side. The lung was scanned
longitudinally moving cranio-caudally to cover all quadrants. To access the
posterior quadrant a lateral rotation of the patient is often necessary.
Interpretation of CXR, CT and TUS have been done and tabulated. SPSS
program (version 22.0 for Windows) was used to conduct the statistical analysis.
Frequency tables with percentages were used for categorical variables and
descriptive statistics (mean and standard deviation) were used for numerical
variables. Either Student-t or ANOVA tests were used to compare quantitative
variables, while Pearson‟s Chi-square test was used to analyze categorical
variables. The sensitivity, specificity, positive predictive value, and accuracy were
calculated for thoracic US in comparison to CT results.
In patients with pleural diseases, airway disease, pneumonia and ILD, the
mean age in patients with pleural diseases was 55.4±11.69 years, in patients with
airway disease was 57.1±12.05 years, in patients with pneumonia was 52.3±12.4 years and in patients with ILD was 55.4±5.02 years. Pleural diseases included 28
female and 49 males, 7 females and 21, males were in patients with airway
disease, 27 females and 25 males were in patients with pneumonia and 7 females
and 1 male were in patients with ILD. There was a high statistical significant
differences regarding cough, expectoration, fever and haemptysis between 4
diseases above. Abnormal blood gases were found mainly in patients with airway
and ILD diseases as type 2RF in airway disease and type 1RF in ILD. The TLC
was markedly increased in patients with pneumonia and showed high significant
statistical differences between others.