Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5889
Peer-review started: February 19, 2021
First decision: March 11, 2021
Revised: March 19, 2021
Accepted: June 1, 2021
Article in press: June 1, 2021
Published online: July 26, 2021
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.
To evaluate the quantitative assessment of pleural line movement measured by tissue Doppler imaging (TDI) for pneumothorax diagnosis.
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 (PSmax), peak chest wall tissue strain value (CSmax), PVmax/CVmax and PSmax/CSmax. The receiver operating characteristic analysis was used to evaluate the performance of these quantitative assessments for pneumothorax diagnosis.
Various quantitative variables of the pneumothorax side were all lower than that of the non-pneumothorax side and included the PVmax (0.36 cm/s vs 0.59 cm/s, P < 0.001), PSmax (1.14% vs 1.90%, P = 0.001), PVmax/CVmax (1.06 vs 4.93, P < 0.001), and PSmax/CSmax (0.76 vs 1.74, P < 0.001). For the discrimination of pneumothorax, the cut-off values of the PVmax, PSmax, PVmax/CVmax, and PSmax/CSmax were calculated as 0.50 cm/s, 0.94%, 1.96, and 1.12, respectively. Similarly, the sensitivities and specificities of PVmax, PSmax, PVmax/CVmax, and PSmax/CSmax 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 PVmax, PSmax, PVmax/CVmax, and PSmax/CSmax.
Quantification analysis of pleural line movement using TDI is a useful tool for the diagnosis of pneumothorax.
Core Tip: This study used tissue Doppler to quantify the movement of the pleural line for the diagnosis of pneumothorax in patients with unilateral pneumothorax. Various quantitative variables of the pneumothorax side were all lower than that of the non-pneumothorax side. Peak pleural line velocity/peak chest wall tissue velocity was the best variable to diagnose pneumothorax (area under receiver operating characteristic curve, 0.99). Tissue Doppler quantitative technique is an effective tool for the diagno