Comparison of A-mode ultrasound and computed tomography: Detection of secretion in maxillary and frontal sinuses in ventilated patients

Objective To study the accuracy of A-mode ultrasonography (A-MU) in detecting secretion in maxillary and frontal sinuses in critically ill, intubated patients undergoing mechanical ventilation.Design Open study in mechanically ventilated, comatose patients.Setting Medical-surgical intensive care unit in the General Hospital of Rovigo.Patients 50 consecutive, mechanically ventilated, critically ill patients. All patients were in a coma and needed cerebral computed tomography (CT) for a diagnosis.Measurements and results The A-MU technique gave 100 images of maxillary and frontal sinuses. The images were read blindly and classified into five categories: definitely normal, definitely abnormal, probably normal, questionable, and probably abnormal. CT findings were considered to be the gold standard. The specificity of echo images varied from 72 to 98% and the sensitivity from 63 to 86% for maxillary sinuses. For frontal sinuses, the specificity varied from 96 to 99% and the sensitivity from 14 to 57%. The area under the receiver-operating characteristic curve was found to be 0.89 and 0.76 for maxillary and frontal sinuses, respectively.Conclusions The A-MU technique is an accurate tool for detecting secretion in the maxillary sinuses in intubated patients. More investigations are necessary in order to evaluate its usefulness in the frontal sinuses.The work was done at the General Hospital, Rovigo, Italy