Diagnostic Value of Sonography in Detecting Hemothorax and its Size in Blunt Trauma Patients

Hemothorax is one of the most prevalent complications after thoracic trauma. Extended Focused Assessment with Sonography for Trauma (e-FAST) is one of the diagnostic methods for hemothorax assessment. This study aimed to assess the diagnostic value of e-FAST in detecting hemothorax and its size in patients with blunt thoracic trauma.

This cross-sectional diagnostic assessment was conducted on 400 adult patients with blunt trauma who needed a chest CT scan. Chest X-ray (CXR), sonography, and chest CT scans were performed and hemothorax size was assessed with sonography and CT-scan. Sensitivity, specificity, and positive or negative predictive values of sonography and CXR were calculated. Hemothorax size on sonography was compared with the results of CT-scan as the gold standard.

The mean age of participants was 43.67±22.03. Based on CT scan findings, 176 participants (44%) had a hemothorax. The sensitivity, specificity, positive and negative predictive values, and correct classification rate of sonography were 79%, 99.1%, 98.6%, 85.7%, and 90.2%, respectively. The accuracy of sonography was 97.1% for small hemothorax, 46.9% for medium hemothorax, and 33.3% for large hemothorax.

Sonography is a sensitive diagnostic modality for the detection of hemothorax in multiple trauma patients but tends to underestimate moderate to large-sized hemothorax. Chest sonography can be an acceptable imaging modality if a CT scan is not available or desired.