| 摘要: |
| 摘要 目的 探讨经胸肺部超声（TLUS）Buda评分法评估间质性肺疾病（ILD）的可行性，并与高分辨率CT（HRCT）评估相比较。方法 收集本院呼吸内科、免疫内科住院的临床怀疑ILD的病人50例，所有患者均采用TLUS及HRCT两种方法对肺部进行检查，评估两种检查方法的诊断效能和一致性。采用Buda超声评分法对ILD进行评分，分析其与HRCT Warrick评分测值在不同严重程度ILD的差异，并评价两种方法的相关性。结果 1、ILD常见的肺部声像图包括B线、胸膜线改变及Am线。2、TLUS诊断ILD的敏感性、特异性、阳性预测值、阴性预测值分别为0.923，0.818，0.947，0.750；HRCT的分别为0.974，0.909，0.974，0.909；两者的诊断效能无明显差异（P＞0.05）。3、TLUS与HRCT对不同程度ILD的诊断具有较强的一致性，Kappa值为0.879（95%CI为0.801-0.958），P＜0.001。4、随着ILD严重程度的增加，Buda超声评分值和HRCT的评分值明显增加。在经胸肺部超声方面，轻度组、中度组均与重度组有明显差异（P均＜0.05），而轻度组与中度组之间没有差异。5、Buda超声评分值与HRCT评分值呈强正相关（r=0.859，P＜0.001）。结论 与HRCT一样，经胸超声可以有效诊断及评估ILD，是一种可供选择的诊断方法。 |
| 关键词: 间质性肺疾病 肺超声 诊断 HRCT |
| DOI： |
| 投稿时间：2020-04-17修订日期：2020-05-26 |
| 基金项目:福建省临床重点专科；母婴健康服务应用技术协同创新中心基金(XJM1802)；福建省卫生计生青年科研课题(2018-1-62)；泉州市科技计划项目(2018N012S) |
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| Comparison of transthoracic lung ultrasound and high resolution CT in the evaluation of interstitial lung diseases |
| zhang ying,Lyu Guorong |
| (Second Affiliated Hospital of Fujian Medical University) |
| Abstract: |
| ABSTRACT Objective To investigate the possibility of transthoracic lung ultrasound(TLUS) Buda score method in evaluating interstitial lung diseases(ILD) and compared with the assessment of high resolution CT(HRCT). Methods A total of 50 patients who were clinically suspected ILD in the respiratory department and immunology department of our hospital were collected. TLUS and HRCT were used to examine all patients. The diagnostic effectiveness and consistency of the two examination methods were evaluated.Buda ultrasound score method was used to score the condition of ILD. Buda ultrasound score method and HRCT Warrick score method were analyzed the difference in different severity of ILD, and the correlation between these two methods were evaluated as well. Results 1. Common lung ultrasound images of ILD included B line, pleural line changes and Am line. 2. The sensitivity, specificity, positive predictive value and negative predictive value of TLUS in diagnosing ILD were 0.923, 0.818, 0.947, 0.750 respectively, and the value of HRCT were 0.974, 0.909, 0.974, 0.909 respectively. There was no significant difference in diagnostic efficiency between the two methods, P＞0.05. 3. There was a strong consistency between TLUS and HRCT in the diagnosis of different severity of ILD, Kappa value = 0.879, 95%CI ( 0.801-0.958), P＜0.001. 4. The values of Buda ultrasound score method and HRCT Warrick score method consistently and significantly increased with the increasing severity of ILD. With regards to the former one, the differences between either the mild type ILD and severe one or the moderate one and the severe one were both statistically significant (P＜0.05), while there was not statistically significant differences between the mild one and the moderate one. 5. There was a strong positive correlation between the values calculated according to either the Buda ultrasound score method or the HRCT Warrick score method (r value = 0.859, P <0.001). Conclusion TLUS which can effectively diagnose and evaluate ILD is an alternative diagnostic method like HRCT. |
| Key words: Interstitial lung diseases Transthoracic lung ultrasound Diagnosis High resolution CT |
