Use of ultrasonography for differentiation between bullae and pneumothorax

Emerg Radiol. 2019 Feb;26(1):15-19. doi: 10.1007/s10140-018-1640-9. Epub 2018 Sep 3.


Purpose: Modern lung ultrasound (US) is mainly applied not only in critical care, emergency medicine, and trauma surgery, but also in pulmonary and internal medicine. In some cases, pneumothorax (PTX) distinguishes with bullous diseases. In this study, we aimed to discuss the success of US on detecting PTX versus bullae.

Methods: We performed a prospective blinded study. Patients underwent thorax computed tomography (CT) if bullae or pneumothorax could not be differentiated from the chest radiography. An emergency medicine specialist trained in lung US and unaware of x-ray and CT findings performed US. All patients US performed from anterior and lateral wall.

Results: Final study population included 81 patients. The sensitivity of the presence of pleural sliding in the diagnosis of bullae was 97.50% (86.84-99.94%), and specificity was 100.0% (91.4-100.0%).

Conclusion: In conclusion, direct visualisation of ultrasonographic pleural sliding can be a good tool for differentiating bullae and pneumothorax.

Keywords: Bullae; Emergency; Pneumothorax; Ultrasonography.

MeSH terms

  • Adult
  • Aged
  • Blister / diagnostic imaging*
  • Diagnosis, Differential
  • Female
  • Humans
  • Lung Diseases / diagnostic imaging*
  • Male
  • Middle Aged
  • Pneumothorax / diagnostic imaging*
  • Prospective Studies
  • Radiography, Thoracic
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed
  • Ultrasonography / methods*