Zheng Xiao-Zhi, Wu Jing, Tan Xu-Yan
Department of Ultrasound, The First People's Hospital of Yancheng, Yancheng, P.R. China.
Department of Ultrasound, Jiangsu Province Tumor Hospital, Nanjing, Jiangsu Province, P.R. China.
Med Ultrason. 2016 Jun;18(2):177-81. doi: 10.11152/mu.2013.2066.182.vly.
To explore the feasibility of quantitative evaluation of pulmonary function in patients with chronic obstructive pulmonary disease (COPD) using tissue velocity imaging (TVI) and strain rate imaging (SRI) via transthoracic lung ultrasonography.
Eighty inpatients with clinically diagnosed COPD underwent pulmonary function test and transthoracic lung ultrasound on the same day. Lung ultrasound variables and pulmonary function parameters were analyzed.
All patients with COPD had faster breathing and significant reduced lung function compared with healthy participants (p<0.05). The lung ultrasound parameters, velocity (max-min, cm/s), displacement (max-min, mm), strain (max-min, %) and strain rate (max-min, 1/s) were significantly higher in patients with COPD (p<0.05). A good negative correlation was found between lung ultrasound variables and pulmonary function parameters in patients with COPD. Stepwise multiple regression analysis indicated that the velocity (max-min, cm/s) was the only independent determinant of FEV1/FVC (%). With the use of FEV1/FVC<70% as the criteria of irreversible pulmonary function impairment to distinguish an abnormal pulmonary function, the area under the ROC was 0.99 for the velocity (max-min, cm/s) of the lung tissue in the process of breathing. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the cut off value (1.19 cm/s) was 97.63%, 100%, 100%, 80%, and 98%, respectively (p<0.001).
Tissue velocity imaging via transthoracic lung ultrasound is a useful modality in the assessment of pulmonary function in patients with COPD.
探讨经胸肺超声组织速度成像（TVI）和应变率成像（SRI）对慢性阻塞性肺疾病（COPD）患者肺功能进行定量评估的可行性。
80例临床诊断为COPD的住院患者于同日接受肺功能检查及经胸肺超声检查。分析肺超声变量及肺功能参数。
与健康参与者相比，所有COPD患者呼吸更快且肺功能显著降低（p<0.05）。COPD患者的肺超声参数，速度（最大-最小，cm/s）、位移（最大-最小，mm）、应变（最大-最小，%）和应变率（最大-最小，1/s）显著更高（p<0.05）。COPD患者的肺超声变量与肺功能参数之间存在良好的负相关。逐步多元回归分析表明，速度（最大-最小，cm/s）是FEV1/FVC（%）的唯一独立决定因素。以FEV1/FVC<70%作为不可逆肺功能损害的标准来区分异常肺功能，呼吸过程中肺组织速度（最大-最小，cm/s）的ROC曲线下面积为0.99。截断值（1.19 cm/s）的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为97.63%、100%、100%、80%和98%（p<0.001）。
经胸肺超声组织速度成像在评估COPD患者肺功能方面是一种有用的方法。
