Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2021; 9(21): 5889-5899
Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5889
Quantification analysis of pleural line movement for the diagnosis of pneumothorax
Rui Xiao, Qiang Shao, Ning Zhao, Fen Liu, Ke-Jian Qian
Rui Xiao, Qiang Shao, Ning Zhao, Fen Liu, Ke-Jian Qian, Department of Intensive Care Medicine, First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Author contributions: Xiao R and Qian KJ were the guarantors and designed the study; Xiao R and Zhao N participated in the acquisition, analysis, and interpretation of the data, and drafted the initial manuscript; Shao Q and Liu F revised the manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of the First Affiliated Hospital of Nanchang University.
Informed consent statement: Written consent was obtained from all subjects.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ke-Jian Qian, MD, PhD, Full Professor, Department of Intensive Care Medicine, First Affiliated Hospital of Nanchang University, No. 17 Yongwaizheng Road, Nanchang 330006, Jiangxi Province, China. ndyfyicu@email.ncu.edu.cn
Received: February 19, 2021
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
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 (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.

RESULTS

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.

CONCLUSION

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

Keywords: Lung ultrasound, Pneumothorax, Tissue Doppler imaging, Pleural line movement

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 diagnosis of pneumothorax.