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01.12.2019 | Original research article | Ausgabe 1/2019 Open Access

Multidisciplinary Respiratory Medicine 1/2019

Agreement between chest ultrasonography and chest X-ray in patients who have undergone thoracic surgery: preliminary results

Multidisciplinary Respiratory Medicine > Ausgabe 1/2019
Andrea Smargiassi, Riccardo Inchingolo, Marco Chiappetta, Leonardo Petracca Ciavarella, Stefania Lopatriello, Giuseppe Maria Corbo, Stefano Margaritora, Luca Richeldi
Wichtige Hinweise
Andrea Smargiassi and Riccardo Inchingolo contributed equally to this work.
This work has been accepted as poster discussion at ERS congress, Paris 2018.



Chest Ultrasonography (chest US) has shown good sensibility in detecting pneumothorax, pleural effusions and peripheral consolidations and it can be performed bedside.


The aim of the study was to analyze agreement between chest US and chest X-ray in patients who have undergone thoracic surgery and discuss cases of discordance.


Patients undergoing thoracic surgery were retrospectively selected. Patients underwent routinely Chest X-ray (CXR) during the first 48 h after surgery. Chest US have been routinely performed in all selected patients in the same date of CXR. Chest US operators were blind to both reports and images of CXR. Ultrasonographic findings regarding pneumothorax (PNX), subcutaneous emphysema (SCE), lung consolidations (LC), pleural effusions (PE) and hemi-diaphragm position were collected and compared to corresponding CXR findings. Inter-rater agreement between two techniques was determined by Cohen’s kappa-coefficient.


Twenty-four patients were selected. Inter-rater agreement showed a moderate magnitude for PNX (Cohen’s Kappa 0.5), a slight/fair magnitude for SCE (Cohen’s Kappa 0.21), a fair magnitude for PE (Cohen’s Kappa 0.39), no agreement for LCs (Cohen’s Kappa 0.06), high levels of agreement for position of hemi-diaphragm (Cohen’s Kappa 0.7).


Analysis of agreement between chest X-ray and chest US showed that ultrasonography is able to detect important findings for surgeons. Limitations and advantages have been found for both chest X-ray and chest US. Knowing the limits of each one is important to really justify and optimize the use of ionizing radiations.
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