Volpicelli Giovanni
Emergency Medicine, San Luigi Gonzaga University Hospital, Torino, Italy.
Praxis (Bern 1994). 2014 Jun 4;103(12):711-6. doi: 10.1024/1661-8157/a001690.
Point-of-care lung ultrasound represents an emerging and useful technique in the management of pulmonary diseases. For many years, thoracic ultrasonography was limited to the study of pleural effusion and thoracic superficial masses because alveolar air and bones of the thoracic cage limit the propagation of the ultrasound beam. Only recently has been highlighted that, by the fact, lung ultrasound works like a real densitometer that is highly sensitive to variations of the pulmonary content and balance between air and fluids. Dynamic and static analysis of a combination of sonographic artifacts and real images makes it possible an accurate diagnosis of many lung disorders, particularly when lung ultrasound is applied in the emergency and critical care setting. Sonography is useful in the diagnostic process of lung diseases where the alveolar air is reduced and interstitial fluids are increased, but also when air or fluids are collected in the pleural space. This article analyzes the basic principles of point-of-care lung ultrasound and all the supposed limitations to the diagnostic usefulness of this technique. Moreover, the article reviews the three main fields of application for lung ultrasound: interstitial, alveolar and pleural syndromes.
床旁肺部超声是肺部疾病管理中一项新兴且实用的技术。多年来,胸部超声检查仅限于对胸腔积液和胸部浅表肿物的研究,因为肺泡内的气体和胸廓骨骼限制了超声束的传播。事实上,直到最近才有人强调,肺部超声就像一台真正的密度计,对肺内容物的变化以及气体与液体之间的平衡高度敏感。对超声伪像和真实图像组合进行动态和静态分析,使得准确诊断多种肺部疾病成为可能,尤其是在急诊和重症监护环境中应用肺部超声时。超声检查在肺部疾病的诊断过程中很有用,这些疾病包括肺泡内气体减少和间质液增加的情况,以及气体或液体积聚在胸腔内的情况。本文分析了床旁肺部超声的基本原理以及该技术在诊断实用性方面所有可能存在的局限性。此外,本文还回顾了肺部超声的三个主要应用领域:间质综合征、肺泡综合征和胸膜综合征。