الفهرس 
Thoracic Computed TomographyOnly 14 pages are availabe for public view
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Abstract
Respiratory disorders continuous to be a major cause of morbidity and mortality among patients admitted to intensive care unit (ICU). There is a consensus in the published literature about the high accuracy of CT scan in the diagnosis of different respiratory disorders, which has become firmly established as the gold-standard diagnostic tool.
On the other hand, the chest X-ray is the initial diagnostic procedure for many emergencies among patients hospitalized in ICU as and it was reported to be the most frequent radiological tests performed in ICU. However, there are raising concerns about the high rates of false positive X-ray findings which may lead to potential harm from unnecessary treatment.
Additionally, the variable interpretation of chest X-ray findings, depending on clinician and patient factors, and adverse events arising from radiation exposure are another limiting factors. Therefore, we performed the present prospective study in order to evaluate the diagnostic accuracy of chest X-ray, compared to CT scan, for early detection of pulmonary complications for adults hospitalized in intensive care unit.
We included 40 patients who had primary respiratory manifestations or started to develop respiratory manifestations during ICU stay. The study group included 10 patients with pleural effusion, 10 patients with pneumonia, 10 patients with pulmonary embolism, and 10 patients with pneumothorax. The chest X-ray sensitivity for the detection of pleural effusion was 70% and the positive predictive value was 100%. Similarly, the chest X-ray sensitivity for the detection of pneumonia was 70% and the positive predictive value was 100.
While the chest X-ray sensitivities for the detection of pneumonia and pulmonary embolism were 50% and the positive predictive values were 100%. In our cohort of patients with a wide variety of chest disorders, routine chest X-ray is not useful to clinicians in the diagnosis of lung disease, compared to chest CT. In addition, chest X-ray has a very low sensitivity in specific conditions like pulmonary embolism and pneumothorax.
However, further studies involving different methodologies and larger patient series are now needed to reveal the benefits of chest X-ray and to enable it to be included in algorithms as a complementary diagnostic tool.