Suppr超能文献

经胸超声检查在排除介入后气胸和液气胸方面的准确性。与胸部X线摄影的比较。

Accuracy of transthoracic sonography in excluding post-interventional pneumothorax and hydropneumothorax. Comparison to chest radiography.

作者信息

Reissig Angelika, Kroegel Claus

机构信息

Pneumology & Allergology, Department I, Medical University Clinics, Friedrich-Schiller-University, Erlanger Allee 101, D-07740 Jena, Germany.

出版信息

Eur J Radiol. 2005 Mar;53(3):463-70. doi: 10.1016/j.ejrad.2004.04.014.

Abstract

OBJECTIVE

Transthoracic sonography (TS) has evolved as an important imaging technique for diagnosing pleural and pulmonary conditions. However, the value of TS in either excluding or diagnosing pneumothorax is still under debate. This study was conducted to examine whether TS could replace chest radiography for the diagnosis of post-interventional pneumothorax and hydropneumothorax.

METHODS

53 patients (21 females, 32 males; median age 64 years, range 37-94 years), 35 of whom underwent transbronchial biopsy (TBB) and 18 patients who had an ultrasound-guided chest tube placement (U-GCTP) were enrolled in the study. TS was performed three hours after either TBB or removal of a chest tube, followed by postero-anterior chest radiograph (CRX). If any discrepancy between TS, the clinical presentation and the CRX became apparent, either a lateral CRX or a computed tomography (CT) of the thorax was performed. TS was assessed according to the presence of the following criteria: (1) "gliding sign" of the pleural line, (2) comet tail artifacts, (3) reverberation artifacts, (4) air/fluid mirror, (5) hyperechoic reflectors within the pleural effusion and (6) "lung point".

RESULTS

In four out of the 53 patients (7.5%) a post-interventional pneumothorax or hydropneumothorax occurred. One out of the 35 patients (2.9%) developed a pneumothorax after TBB, requiring chest tube placement. Three patients (16.7%) developed a hydropneumothorax due to U-GCTP which was detected by sonography but was missed by postero-anterior CRX in one patient. The sensitivity, specificity and accuracy of TS were 100% in excluding post-interventional pneumothorax/hydropneumothorax.

CONCLUSION

TS is a cost-effective and safe bed-side-method, allowing for an immediate exclusion or diagnosis of post-interventional pneumothorax/hydropneumothorax in patients who have undergone TBB or U-GCTP. Thus, these preliminary results suggest that CXR may only be required in patients with pneumothorax diagnosed by TS in order to assess its extension or to exclude any discrepancy between the TS-result and the clinical presentation.

摘要

目的

经胸超声检查(TS)已发展成为诊断胸膜和肺部疾病的一项重要成像技术。然而,TS在排除或诊断气胸方面的价值仍存在争议。本研究旨在探讨TS能否替代胸部X线摄影用于诊断介入术后气胸和液气胸。

方法

53例患者(21例女性,32例男性;中位年龄64岁,范围37 - 94岁)纳入研究,其中35例行经支气管活检(TBB),18例行超声引导下胸腔置管(U - GCTP)。在TBB或拔除胸腔引流管3小时后进行TS检查,随后行后前位胸部X线摄影(CRX)。如果TS、临床表现和CRX之间出现任何差异,则进行侧位CRX或胸部计算机断层扫描(CT)。根据以下标准评估TS:(1)胸膜线的“滑动征”;(2)彗尾伪像;(3)混响伪像;(4)气/液界面;(5)胸腔积液内的高回声反射;(6)“肺点”。

结果

53例患者中有4例(7.5%)发生介入术后气胸或液气胸。35例患者中有1例(2.9%)在TBB后发生气胸,需要放置胸腔引流管。3例患者(16.7%)因U - GCTP发生液气胸,超声检查检测到,但1例患者后前位CRX漏诊。TS排除介入术后气胸/液气胸的敏感性、特异性和准确性均为100%。

结论

TS是一种经济有效且安全的床旁检查方法,可立即排除或诊断接受TBB或U - GCTP的患者的介入术后气胸/液气胸。因此,这些初步结果表明,对于TS诊断为气胸的患者,可能仅需进行CXR以评估气胸范围或排除TS结果与临床表现之间的差异。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验