Table 2 The diagnostic criteria of chest X-ray, US and CT scan to determine lung injuries in our settings
Diagnostic criteria | PTX | HTX | Contusion |
|---|---|---|---|
Chest X-ray | A thin dense line as the visceral pleural edge separating from the parietal pleura, the distance between the 2 pleurae is radiolucent usually accumulating in the periphery and sometimes deep lucent lateral costophrenic angle | In the presence of sufficient amount of blood, the involved hemithorax is hazy. If upright film is performed, the costophrenic sulcus become blunted. | Alveolar infiltration, irregular patchy consolidation that usually evolve within the first 6 h |
US | Absence of lung sliding and the presence of stratosphere sign and the absence of B lines with or without “lung point” | Dependent collection above diaphragm with or without the sinusoidal movement of collapsed lung in inspiration in the B and M mode scan, the presence of V line | Three B lines in at least 2 zone scans, alveolo-interstitial syndrome (AIS), peripheral parenchymal lesions (PPL) and punctiform hyperechoic lesions without respiratory alterations |
CT scan | In the pulmonary window, the existence of air in pleural space that may collapse the adjacent lung | Blood in the pleural space with Hounsfield Unit of about 45–65 in the mediastinal window | An interstitial or alveolar lung injury, usually focal and non-segmental peripheral opacification in lung parenchyma in lower lobes |