肺部B线伪像及其应用。
Lung B-line artefacts and their use.
作者信息
Dietrich Christoph F, Mathis Gebhard, Blaivas Michael, Volpicelli Giovanni, Seibel Armin, Wastl Daniel, Atkinson Nathan S S, Cui Xin-Wu, Fan Mei, Yi Dong
机构信息
1 Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China ; 2 Caritas Krankenhaus Bad Mergentheim, Uhlandstr. 7, 97980 Bad Mergentheim, Deutschland ; 3 Praxis for Internal Medicine, Bahnhofstraße 16, 6830 Rankweil, Austria ; 4 University of South Carolina School of Medicine, Department of Emergency Medicine, Piedmont Hospital, Newnan Georgia, USA ; 5 Department of Emergency Medicine, San Luigi Gonzaga University Hospital, Torino, Italy ; 6 Diakonie Klinikum Jung-Stilling, Abteilung für Anästhesiologie, Intensiv- und Notfallmedizin, 57074 Siegen, Deutschland ; 7 Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK ; 8 Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China ; 9 Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
出版信息
J Thorac Dis. 2016 Jun;8(6):1356-65. doi: 10.21037/jtd.2016.04.55.
BACKGROUND
The analysis of lung artefacts has gained increasing importance as markers of lung pathology. B-line artefact (BLA), caused by a reverberation phenomenon, is the most important lung artefact. In this review, we discuss the current role of BLA in pneumology and explore open questions of the published consensus.
METHODS
We summarized current literature about BLA. Also, we presented observations on healthy subjects and patients with interstitial syndrome (pulmonary fibrosis and edema), to investigate technical factors influencing BLA visualization.
RESULTS
BLA imaging is influenced by more factors than recently assumed. When multiple BLA is visualized in the lung, they represent a sign of increased density due to the loss of aeration in the lung periphery. This condition may indicate different diseases including cardiogenic pulmonary edema, diffuse or focal interstitial lung diseases (ILD), infections and acute respiratory distress syndrome (ARDS). Correct interpretation of BLA in lung ultrasound is strongly influenced by associated sonographic signs and careful integration of all relevant clinical information.
CONCLUSIONS
BLA is useful to monitor clinical response, and may become crucial in directing the diagnostic process. Further research is warranted to clarify technical adjustments, different probe and machine factors that influence the visualization of BLA.
背景
作为肺部病理学的标志物，肺部伪像的分析变得越来越重要。由混响现象引起的B线伪像（BLA）是最重要的肺部伪像。在本综述中，我们讨论了BLA在肺病学中的当前作用，并探讨了已发表共识中存在的未决问题。
方法
我们总结了有关BLA的当前文献。此外，我们展示了对健康受试者和间质性综合征（肺纤维化和水肿）患者的观察结果，以研究影响BLA可视化的技术因素。
结果
影响BLA成像的因素比最近所认为的更多。当在肺部观察到多条BLA时，它们代表肺外周通气丧失导致的密度增加迹象。这种情况可能提示不同疾病，包括心源性肺水肿、弥漫性或局灶性间质性肺病（ILD）、感染和急性呼吸窘迫综合征（ARDS）。肺部超声中BLA的正确解读受到相关超声征象以及所有相关临床信息的仔细整合的强烈影响。
结论
BLA有助于监测临床反应，并且在指导诊断过程中可能变得至关重要。有必要进行进一步研究以阐明影响BLA可视化的技术调整、不同探头和机器因素。
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