ARTIK ELİMİZDE DAHA FAZLA KANIT VAR; ULTRASONOGRAFİ KABURGA KIRIKLARININ GÖSTERİLMESİNDE GÜVENİLİR BİR ARAÇTIR

Year 2024, , 438 - 442, 21.10.2024

Elif Dilara Topcuoğlu , Sinan Cem Uzunget , Tevfik Kaplan , Zamir Kemal Ertürk , Gökçe Kaan Ataç

https://doi.org/10.18229/kocatepetip.1394202

Abstract

AMAÇ: Bu çalışmanın amacı künt göğüs travmasında şüpheli kosta kırıklarının ultrasonografi (US) değerlendirmesinde gözlemciler arası güvenilirliği ölçerek US’un tanısal değerini belirlemektir.
GEREÇ VE YÖNTEM: Künt göğüs travması nedeniyle acil servise başvuran ve kosta kırığı şüphesi olan, yaş ortalaması 48 olan (18 ila 95 yaş) toplam 52 hasta (32 erkek, 20 kadın) çalışmaya dahil edildi. Tüm hastaların direk akciğer grafileri ve US incelemeleri iki radyolog (20 yıllık US deneyimi olan bir kıdemli radyolog hekim ve bir yıllık US deneyimi olan bir asistan hekim) tarafından bağımsız şekilde değerlendirildi.
BULGULAR: Akciğer grafisinde sadece iki kosta kırığı tespit edildi. Her iki radyolog tarafından yapılan US incelemede 19 hastada 22 kırık tespit edildi. Sadece bir kosta kırığı kıdemli radyolog hekim tarafından fark edildi, asistan hekim tarafından fark edilmedi. US ile kosta kırığı tespitinde gözlemciler arası uyum çok iyiydi (Kappa: 0.917) ve bu uyum istatistiksel olarak anlamlıydı (p=0.002). Tüm kırıklar kostanın kemik kısmında yer almaktaydı ve kostal kıkırdak veya kostokondral bileşkede kırık saptanmadı.
SONUÇ: Bu çalışma ile kosta kırığı tanısında US incelemenin, gözlemciler arası değişkenliğinin çok düşük olduğunu ve yüksek oranda tekrarlanabilir bir tanı aracı olduğunu gösterdik.

Keywords

Gözlemciler arası değişkenlik, Kosta kırığı, Radyografi, Ultrasonografi.

WE HAVE MORE EVIDENCE THAN BEFORE; ULTRASONOGRAPHY IS A RELIABLE TOOL TO SHOW RIB FRACTURES

Abstract

OBJECTIVE: The aim of this study is to assess the value of ultrasonography (US) by determining the inter-observer reliability on US evaluation of suspected rib fractures in blunt chest trauma.
MATERIAL AND METHODS: A total of 52 patients (32 males, 20 females) with a mean age of 48 years (18-95 years) who presented to the emergency department with blunt chest trauma and suspected rib fracture were included in the study. All patients were assessed with US by two radiologists (a senior radiologist with 20 years of US experience and a resident with one year of US experience) independently and chest x-rays were also evaluated.
RESULTS: Only two rib fractures were detected on chest x-rays. 22 fractures were detected from 19 patients with US by both radiologists. One rib fracture was noted only by the senior radiologist and not by the resident. Interobserver agreement was very good (kappa: 0.917) and statistically significant (p=0.002). All fractures were located at the bony portion of the rib and no fracture was found at the costal cartilage or costochondral junction.
CONCLUSIONS: We demonstrated that US is a highly reproducible diagnostic tool for rib fractures with very low inter-observer variability.

Keywords

Interobserver variability, Rib fractures, Radiography, Ultrasonography.

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