摘要
目的探讨高频超声对呼吸困难患者胸膜肺部不同病理变化的鉴别诊断价值。方法对88例呼吸困难患者行胸膜肺超声检查，观察胸膜线的形态及胸膜下改变。以CT为参照标准，得出各种征象的敏感性、特异性、阴性预测值、阳性预测值。结果胸膜肺超声的不同胸膜线改变与不同病理变化相对应：“颗粒状胸膜线”提示间质纤维化的敏感性96．0％，特异性96．8％，阳性预测值92．3％阴性预测值98．4％；“欠光滑或杂乱状胸膜线”提示肺炎的敏感性84．1％，特异性92．0％，阳性预测值96．40／4，阴性预测值69．7％；“波浪状胸膜线”提示肺气肿的敏感性43．8oA，特异性96．4％，阳性预测值87．5％，阴性预测值75．0％；“胸膜下实变”诊断肺炎的敏感性84．1％，特异性86．4％，阳性预测值86．0％，阴性预测值84．4％；“团状空气支气管征”诊断支气管扩张的敏感性44．4％，特异性100．0％，阳性预测值100．0％，阴性预测值87．5％。结论高频胸膜肺超声能够通过胸膜线及胸膜下改变对不同肺部病理变化进行初步诊断。
Objective To evaluated the ability of high resolution pleuropulmonary ultrasonography in identifying different pathologic abnormalities in patients with dyspnea. Methods Pleuropulmonary ultrasonography was performed in 88 dyspneic patients. Linear transducer was used to explore the shape of pleural line and subpleural alteration. The results of pleuropulmonary ultrasonography were compared with CT findings. Sensitivity, specificity, and positive/negative predictive values were obtained. Results The characteristic changes of the pleural line can be seen in different pathologic abnormalities：＂Fringed＂ pleural line indicated interstitial fibrosis with 96.0 % sensitivity, 96.8 % specificity, 92.3 % positive predictive values and 98.4% negative predictive value;＂Slightly rough＂ or ＂irregular and interrupted＂ pleural lines indicated pneumonia with 84.1% sensitivity, 92.0% specificity, 96.4% positive predictive values and 69.7% negative predictive values; ＂Wavy＂ pleural line indicated emphysema with 43.8% sensitivity, 96.4% specificity, 87.5 % positive predictive values and 75.0 % negative predictive values;＂Subpleural consolidation＂ indicated pneumonia with 84.1 ~ sensitivity, 86.4% specificity, 86.0% positive predictive values and 84.4% negative predictive values; ＂ Enlarged air bronchogram＂ indicated bronchiectasis with 44.4% sensitivity, 100% specificity, 100% positive predictive values and 87.5% negative predictive values. Conclusions The pathologic changes may be initially identified by changes of pleural line and subpleural alterations using high resolution pleuropulmonary ultrasonography.
出处
《中华超声影像学杂志》
CSCD
北大核心
2016年第4期305-308,共4页
Chinese Journal of Ultrasonography
基金
国家自然科学基金项目（81571683）
首都临床特色应用研究项目（Z141107002514074）
首都卫生发展科研专项项目（2014-2一1061）
