Novikov V A, Galstyan G M, Gemdzh I An E G, Kostina I E, Gitis M K
Anesteziol Reanimatol. 2017 Sep;61:183-189.
To compare the accuracy of bedside lung ultrasound (LUS) and chest computed tomography (CT) for the de- tection of lung lesions in patients with hematological malignancies and acute respiratory failure (ARF).
39 patients with hematological malignancies and ARF were enrolled in prospective study. The investigation of the patients included LUS, chest C, extravascular lung water index (EVLW) by transpulmonary ther- modilution, and bronchoalveolar lavage (BAL).
There was correlation between the total number of B-lines and E VLW index (r = 0,40; p <0,05). The sensitivity, specificity of LUS in the total number of B-lines were 78% and 70%, respectively (and A UC 0,7). There were correla- tions between A-lines and volume of hyperaerated lung regions (r = 0,40; p <0,05) and normally ventilated (r = 0,60; p = 0,001) regions, between A-lines and the total lung volume (r = 0,50; p = 0,001), between A-lines and volume of poorlyventilated lung regions (r = -0,40; p = 0,001), A-lines and weight of normally ventilated lung regions (r = 0,50; p = 0,001), A-lines and weight of poorly ventilated regions (r = -0,35; p <0,05), total count of B-lines and volume of poorly ventilated lung regions (r = 0,4; p = 0,001), between total count of B-lines and weight poorly ventilated lung regions (r = 0,4; p = 0,001). There were associations between USfeathers and etiology ofpneumonia. A-lines were often detected in patients with gram-negative bacterial pneumonia and fungal pneumonia more than in patients with pneu- mocystis pneumonia. B-lines were detected often in patients with Pneumocystis pneumonia. Sensitivity ofLUS pleural effusion assessment was 95%, specificity was 90%.
LUS is high sensitivity and specificity method to detect lung lesions in patients with ARF.
比较床旁肺部超声（LUS）和胸部计算机断层扫描（CT）在血液系统恶性肿瘤合并急性呼吸衰竭（ARF）患者中检测肺部病变的准确性。
39例血液系统恶性肿瘤合并ARF患者纳入前瞻性研究。对患者的检查包括LUS、胸部CT、经肺热稀释法测定血管外肺水指数（EVLW）以及支气管肺泡灌洗（BAL）。
B线总数与EVLW指数之间存在相关性（r = 0.40；p <0.05）。LUS在B线总数方面的敏感性和特异性分别为78%和70%（曲线下面积为0.7）。A线与肺过度充气区域的体积（r = 0.40；p <0.05）、正常通气区域（r = 0.60；p = 0.001）、总肺体积（r = 0.50；p = 0.001）、通气不良肺区域的体积（r = -0.40；p = 0.001）、正常通气肺区域的重量（r = 0.50；p = 0.001）、通气不良区域的重量（r = -0.35；p <0.05）、B线总数与通气不良肺区域的体积（r = 0.4；p = 0.001）、B线总数与通气不良肺区域的重量（r = 0.4；p = 0.001）之间存在相关性。超声羽毛征与肺炎病因之间存在关联。革兰氏阴性菌肺炎和真菌肺炎患者比肺孢子菌肺炎患者更常检测到A线。肺孢子菌肺炎患者常检测到B线。LUS评估胸腔积液的敏感性为95%，特异性为90%。
LUS是检测ARF患者肺部病变的高敏感性和特异性方法。
