Diagnostic accuracy of ultrasound (US) in pleural chest syndromes: evidence from systematic reviews

Number of studiesPopulation, unit of analysisUS features, comparatorReference standardPrevalence and numberSensitivitySpecificity
 Wilkerson 2010 [25]4 studies
No meta-analysis
Blunt trauma,
By patient (3 studies)
By hemithorax (1 study)
Not stated
Chest CT or release of air21.5–30.1% of 497 patients
11.5% of 218 hemithoraces
US: 86–98%
CXR: 28–75%
US: 97–100%
CXR: 100%
 Ding 2011 [24]20 studiesTrauma, post-lung biopsy, critically ill
By hemithorax#
Absent lung sliding, absent comets, lung point
Chest CT or clinical findings and release of air13.2% of 7569 hemithoracesUS: 88%
CXR: 52%
US: 99%
CXR: 100%
 Alrajhi 2012 [27]8 studiesTrauma, iatrogenic
By patient#
Absent lung sliding, absent comets
Chest CT or release of airNot stated (unable to calculate)
1048 patients
US: 90.9%
CXR: 50.2%
US: 98.2%
CXR: 99.4%
 Alrajab 2013 [28]13 studiesTrauma, post-lung biopsy, critically ill
By hemithorax
Not defined
Chest CT22.5% of 3028 hemithoracesUS: 78.6%
CXR: 39.8%
US: 98.4%
CXR: 99.3%
 Ebrahimi 2014 [29]28 studiesTrauma, iatrogenic, critically ill
By patient#
Not stated
Chest CT20% of 5314 patientsUS: 87%
CXR: 46%
US: 99%
CXR: 100%
Pleural effusion
 Grimberg 2010 [30]4 studiesTrauma, heart failure, ICU patients with ARDS
By patient
Not stated
CT or drainage27.6% of 924 patientsUS: 92–96%
CXR: 24–100%
US: 88–100%
CXR: 85–100%
 Yousefifard 2016 [31]12 studiesTrauma, heart failure, critically ill, surgical patients
By patient
Not stated
CT, US, CXR41.5% of 1554 patientsUS: 94%
CXR: 51%
US: 98%
CXR: 91%
  • CXR: chest radiography; CT: computed tomography; ICU: intensive care unit; ARDS: acute respiratory distress syndrome. #: Included and pooled studies reporting the alternative unit of analysis, by either doubling the number of patients or halving the number of hemithoraces in those studies.