Anantham Devanand, Herth Felix J F, Majid Adnan, Michaud Gaëtane, Ernst Armin
Interventional Pulmonology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Respiration. 2009;77(2):166-72. doi: 10.1159/000168784. Epub 2008 Oct 31.
Computerized analysis of the regional distribution of breath sound intensity during respiration has generated interest as a possible diagnostic modality.
We hypothesized that pleural effusions would create a dependent region of absent breath sounds and thus vibration response imaging (VRI) could be used in the detection of such pleural effusions.
A prospective, single-blinded and open-labeled trial was carried out, and VRI recordings were compared to upright chest X-rays, bedside ultrasound examinations and volume of fluid drained via thoracentesis. VRI images were interpreted by a physician who was blinded to the patients' clinical history, physical examination and diagnostic tests. Quantitative assessment of pleural effusion size in the VRI images was performed by ImageJ software and an automatic pixel count analysis.
VRI recordings were performed on 57 consecutive patients and correctly predicted the diagnosis in 45 cases (45/56, 80%) as compared to chest X-rays. The calculated sensitivity, specificity, positive predictive value and negative predictive value for diagnosis of pleural effusion were 86% (62/72), 93% (37/40), 95% (62/65) and 79% (37/47), respectively, in a per-hemithorax analysis. In the quantification of effusion size, there were high correlations between VRI images and chest X-ray area as assessed by ImageJ (r = 0.67) and pixel count (r = -0.77). The level of agreement between VRI readings and ultrasonography was 75% (41/55), and correlation with the volume of fluid drained in therapeutic thoracentesis was moderate (r = -0.49). No side effects from the VRI recordings were documented.
VRI can be used to detect and quantify pleural effusions.
呼吸过程中呼吸音强度区域分布的计算机分析作为一种可能的诊断方式引起了人们的关注。
我们假设胸腔积液会形成一个呼吸音缺失的依赖区域，因此振动反应成像（VRI）可用于检测此类胸腔积液。
进行了一项前瞻性、单盲和开放标签试验，将VRI记录与直立位胸部X线、床边超声检查以及胸腔穿刺抽出的液体量进行比较。VRI图像由一位对患者临床病史、体格检查和诊断测试不知情的医生进行解读。通过ImageJ软件和自动像素计数分析对VRI图像中的胸腔积液大小进行定量评估。
对57例连续患者进行了VRI记录，与胸部X线相比，在45例（45/56，80%）中正确预测了诊断。在每侧胸腔分析中，诊断胸腔积液的计算敏感性、特异性、阳性预测值和阴性预测值分别为86%（62/72）、93%（37/40）、95%（62/65）和79%（37/47）。在积液大小的量化方面，通过ImageJ评估，VRI图像与胸部X线面积之间存在高度相关性（r = 0.67），与像素计数之间存在高度相关性（r = -0.77）。VRI读数与超声检查之间的一致性水平为75%（41/55），与治疗性胸腔穿刺抽出的液体量的相关性中等（r = -0.49）。未记录到VRI记录的任何副作用。
VRI可用于检测和量化胸腔积液。
