CNR Institute of Clinical Physiology, Pisa, Italy.
Cardiology Department, Nottola Hospital, Siena, Italy.
JACC Cardiovasc Imaging. 2018 Nov;11(11):1692-1705. doi: 10.1016/j.jcmg.2018.06.023.
For a cardiologist, lung ultrasound is an add-on to transthoracic echocardiography, just as lung auscultation is part of a cardiac physical examination. A cardiac 3.5- to 5.0-MHz transducer is generally suitable because the small footprint makes it ideal for scanning intercostal spaces. The image quality is often adequate, and the lung acoustic window is always patent. The cumulative increase in imaging time is <1 min for the 2 main applications targeted on pleural water (pleural effusion) and lung water (pulmonary congestion as multiple B-lines). In these settings, lung ultrasound outperforms the diagnostic accuracy of the chest radiograph, with a low-cost, portable, real-time, radiation-free method. A "wet lung" detected by lung ultrasound predicts impending acute heart failure decompensation and may trigger lung decongestion therapy. The doctors of tomorrow may still listen with a stethoscope to their patient's lung, but they will certainly be seeing it with ultrasound.
对于心脏病专家来说，肺部超声是经胸超声心动图的附加检查，就像肺部听诊是心脏体格检查的一部分一样。通常使用 3.5 至 5.0MHz 的心脏探头，因为其较小的探头非常适合扫描肋间隙。图像质量通常足够好，而且肺部声窗始终保持开放。这 2 种主要应用（针对胸腔积液和肺水肿）的累积成像时间增加均<1 分钟，超声探头的数量为 B 线。在这些情况下，肺部超声的诊断准确性优于胸部 X 线摄影，具有低成本、便携、实时、无辐射的优势。肺部超声检测到的“湿肺”可预测急性心力衰竭失代偿即将发生，并可能引发肺部去充血治疗。明天的医生可能仍然会用听诊器听诊患者的肺部，但他们肯定会用超声来观察肺部。
