Prone Chest Radiographs: Distinguishing Features and Identification of Support Devices.
AuthorLazarus, Matthew S
Villasana, Geraldine M
Herring, Allison A
Levsky, Jeffrey M
White, Charles S
Haramati, Linda B
MetadataShow full item record
AbstractPurpose: Prone position is known to improve acute lung injury, and chest radiographs are often necessary to monitor disease and confirm support device placement. However, there is a paucity of literature regarding radiographs obtained in this position. We evaluated prone radiographs for distinguishing features and ability to identify support devices. Methods: Pairs of prone and supine radiographs obtained during the COVID-19 pandemic were assessed retrospectively. IRB approval and waiver of informed consent were obtained. Radiographs were assessed for imaging adequacy, distinguishing features, and support device identification (endotracheal tube, enteric tube, or central line). Radiographs were reviewed by ≥ 2 cardiothoracic radiologists. Results: Radiographs from 81 patients (63yo ± 13, 30% women) were reviewed. Prone and supine radiographs were comparable for imaging the lung bases (81% vs. 90%, p = 0.35) and apices (93% vs. 94%, p = 1); prone radiographs more frequently had significant rotation (36% vs. 19%, p = 0.021). To identify prone technique, scapula tip located beyond the rib border was 89% sensitive (95%CI 80-95%) and 85% specific (76-92%), and a fundal stomach bubble was 44% sensitive (33-56%) and 90% specific (81-96%). For women, displaced breast shadow was 46% sensitive (26-67%) and 92% specific (73-99%). Prone and supine radiographs each identified > 99% of support devices. Prone exams trended toward increased rate of malpositioned device (12% vs. 6%, p = 0.07). Conclusion: Scapula position reliably distinguishes prone from supine position; fundal stomach bubble or displaced breast shadow is specific for prone position. Prone radiographs reliably identify line and tube position, which is particularly important as prone patients appear at increased risk for malpositioned devices.
Rights/Terms© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/19255
- CT-guided Lung Biopsy: Effect of Biopsy-side Down Position on Pneumothorax and Chest Tube Placement.
- Authors: Drumm O, Joyce EA, de Blacam C, Gleeson T, Kavanagh J, McCarthy E, McDermott R, Beddy P
- Issue date: 2019 Jul
- High-resolution CT of the lung: determination of the usefulness of CT scans obtained with the patient prone based on plain radiographic findings.
- Authors: Volpe J, Storto ML, Lee K, Webb WR
- Issue date: 1997 Aug
- Sensitivity of bedside ultrasound and supine anteroposterior chest radiographs for the identification of pneumothorax after blunt trauma.
- Authors: Wilkerson RG, Stone MB
- Issue date: 2010 Jan
- Comparison of prone versus supine 18F-FDG-PET of locally advanced breast cancer: Phantom and preliminary clinical studies.
- Authors: Williams JM, Rani SD, Li X, Arlinghaus LR, Lee TC, MacDonald LR, Partridge SC, Kang H, Whisenant JG, Abramson RG, Linden HM, Kinahan PE, Yankeelov TE
- Issue date: 2015 Jul
- The impact of imaging modality (CT vs MRI) and patient position (supine vs prone) on tangential whole breast radiation therapy planning.
- Authors: Dundas K, Pogson EM, Batumalai V, Delaney GP, Boxer MM, Yap ML, Ahern V, Chan C, David S, Dimigen M, Harvey JA, Koh ES, Lim K, Papadatos G, Lazarus E, Descellar J, Metcalfe P, Holloway L
- Issue date: 2018 May - Jun