BACKGROUND Ultrasound (US) has been used in the adult trauma population with reported moderate to high sensitivities, but data are scarce in the pediatric trauma population. OBJECTIVE The purpose of this study was to specifically examine the sensitivity and specificity of one lung US methodology (single-point anterior exam) in the pediatric trauma population when compared to chest radiography or CT. MATERIALS AND METHODS We conducted a retrospective review of pediatric trauma patients who received lung US as an extension of the focused assessment with sonography for trauma (FAST) exam. We compared lung US findings with chest radiography and CT scans. RESULTS Two hundred twenty-six pediatric trauma patients underwent lung US exam with confirmatory exams; 11 pneumothoraces (4.8%) were observed. Of those 11, 6 were evaluated as false negatives on the lung US. Analyses resulted in 45.5% sensitivity, 98.6% specificity and 96.0% accuracy. Pneumothoraces undetected by lung US were small and apical and were likely not observed because of their size and location. None of the false negatives required intervention. All true positives were associated with lung contusions. CONCLUSION Pneumothorax is less common in the pediatric than the adult trauma population, and when encountered in children pneumothorax is often occult and might be associated with lung contusions. Existing evidence supports the usefulness of chest US in detecting pneumothorax in adults and suggests that it can be translated to injured children. However, our findings suggest that the sensitivity of lung US as a single-point anterior exam extension of the FAST exam might not be as reliable in the pediatric trauma population as in adults. Other methodologies using lung US might improve sensitivity.

中文翻译：

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肺部超声检测受伤儿童的气胸：在社区二级儿童创伤中心的初步经验。

背景技术超声（US）已经被用于成人创伤人群，据报道其敏感性中等至高，但是在儿科创伤人群中数据很少。目的本研究的目的是与胸片或CT相比，专门检查一种肺部US方法（单点前检查）在小儿创伤人群中的敏感性和特异性。材料与方法我们对接受肺部超声检查的小儿外伤患者进行了回顾性研究，作为针对性超声检查（FAST）的重点评估的扩展。我们将肺部US检查结果与胸部X线检查和CT扫描进行了比较。结果262例小儿创伤患者接受了肺部US检查并进行了确证检查。观察到11例气胸（4.8％）。在这11个人中 在肺US上有6个被评估为假阴性。分析得到45.5％的灵敏度，98.6％的特异性和96.0％的准确性。肺部US未检出的气胸小而根尖，可能由于其大小和位置而未被观察到。没有一个假阴性需要干预。所有真实阳性都与肺挫伤有关。结论气胸在儿科中比成人创伤人群少见，并且在儿童中遇到气胸通常是隐匿的，可能与肺挫伤有关。现有证据支持胸部US在检测成人气胸中的有用性，并建议可以将其翻译为受伤的儿童。然而，我们的研究结果表明，在小儿创伤人群中，肺动脉超声作为FAST检查的单点前检查扩展的敏感性可能不如成人可靠。其他使用肺部超声的方法可能会提高敏感性。