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Volume 14
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10.3390/jcm14092978
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Elastography Versus B-Mode Lung Ultrasound for the Diagnosis of Iatrogenic Pneumothorax: An Observational, Monocentric, Prospective Study

by
Gian Piero Bandelli
1,
Ilaria Bassi
2,3,
Alessandro Zanforlin
4,
Riccardo Inchingolo
5,
Martina Ferioli
1,*,
Alessandro Cipolli
6,
Arianna Johanna De Grauw
7,
Marco Ferrari
1,
Thomas Galasso
1,
Filippo Natali
1,
Tommaso Abbate
1,
Francesco Buia
8,
Domenico Attinà
8,
Fabio Niro
8,
Luciana Ingraldi
8,
Elena Nardi
9,
Luigi Lovato
8 and
Piero Candoli
1
1
Interventional Pulmonology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
2
Alma Mater Studiorum, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
3
Respiratory and Critical Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
4
Service of Pulmonology, Health District of Bolzano (SABES-ASDAA), Teaching Hospital of Paracelsus Medizinischen Privatuniversität, 39100 Bolzano-Bozen, Italy
5
UOC Pneumologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
6
Division of Thoracic Surgery, IRCCS University of Bologna, 40138 Bologna, Italy
7
Pulmonology Unit, Morgagni Pierantoni Hospital, 47121 Forlì, Italy
8
Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology Unit, UOC di Radiologia, Radiologia Cardiovascolare, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
9
Epidemiology and Statistics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(9), 2978; https://doi.org/10.3390/jcm14092978
Submission received: 17 February 2025 / Revised: 6 April 2025 / Accepted: 22 April 2025 / Published: 25 April 2025
(This article belongs to the Special Issue Interventional Pulmonology: Advances and Future Directions)
Versions Notes

Abstract

Background: Thoracic ultrasound (TUS) has emerged as a viable alternative of computed tomography (CT) for pneumothorax diagnosis. Ultrasound elastography (USE), a technique assessing tissue elasticity, has recently been proposed as a novel tool for pneumothorax evaluation. Methods: This prospective, monocentric, observational study aimed to compare the diagnostic accuracy of static and dynamic USE with TUS in detecting iatrogenic pneumothorax after CT-guided transthoracic needle aspiration (TTNA). Results: Thirty-two patients were enrolled, with pneumothorax confirmed via CT in 40.63% of cases. The results showed that elastographic-mode images had significantly higher sensitivity (76.9% vs. 21.2%, p < 0.001) and improved positive and negative predictive values (67.8% vs. 52.4%, p-value 0.01, 82.6% vs. 61.7%, p-value < 0.001, respectively), compared to B-mode images. Concordance between expert and non-expert evaluators was also higher for elastographic images, suggesting improved interpretability. However, dynamic USE did not demonstrate a statistically significant advantage over B-mode videos. Conclusions: These findings suggest that USE may enhance static ultrasound-based pneumothorax detection and provide an objective imaging marker for reports. Further multicenter studies are needed to confirm these findings and explore the potential role of USE in other settings.
Keywords: chest ultrasound; elastography; pneumothorax; iatrogenic pneumothorax; B-mode chest ultrasound; elastography; pneumothorax; iatrogenic pneumothorax; B-mode

Share and Cite

MDPI and ACS Style

Bandelli, G.P.; Bassi, I.; Zanforlin, A.; Inchingolo, R.; Ferioli, M.; Cipolli, A.; De Grauw, A.J.; Ferrari, M.; Galasso, T.; Natali, F.; et al. Elastography Versus B-Mode Lung Ultrasound for the Diagnosis of Iatrogenic Pneumothorax: An Observational, Monocentric, Prospective Study. J. Clin. Med. 2025, 14, 2978. https://doi.org/10.3390/jcm14092978

AMA Style

Bandelli GP, Bassi I, Zanforlin A, Inchingolo R, Ferioli M, Cipolli A, De Grauw AJ, Ferrari M, Galasso T, Natali F, et al. Elastography Versus B-Mode Lung Ultrasound for the Diagnosis of Iatrogenic Pneumothorax: An Observational, Monocentric, Prospective Study. Journal of Clinical Medicine. 2025; 14(9):2978. https://doi.org/10.3390/jcm14092978

Chicago/Turabian Style

Bandelli, Gian Piero, Ilaria Bassi, Alessandro Zanforlin, Riccardo Inchingolo, Martina Ferioli, Alessandro Cipolli, Arianna Johanna De Grauw, Marco Ferrari, Thomas Galasso, Filippo Natali, and et al. 2025. "Elastography Versus B-Mode Lung Ultrasound for the Diagnosis of Iatrogenic Pneumothorax: An Observational, Monocentric, Prospective Study" Journal of Clinical Medicine 14, no. 9: 2978. https://doi.org/10.3390/jcm14092978

APA Style

Bandelli, G. P., Bassi, I., Zanforlin, A., Inchingolo, R., Ferioli, M., Cipolli, A., De Grauw, A. J., Ferrari, M., Galasso, T., Natali, F., Abbate, T., Buia, F., Attinà, D., Niro, F., Ingraldi, L., Nardi, E., Lovato, L., & Candoli, P. (2025). Elastography Versus B-Mode Lung Ultrasound for the Diagnosis of Iatrogenic Pneumothorax: An Observational, Monocentric, Prospective Study. Journal of Clinical Medicine, 14(9), 2978. https://doi.org/10.3390/jcm14092978

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