肺部超声表面波弹性成像在间质性肺疾病分期中的应用。
Lung US Surface Wave Elastography in Interstitial Lung Disease Staging.
机构信息
From the Departments of Radiology (B.Z., B.J.B., X.Z.), Pulmonary and Critical Care Medicine (S.K.), and Rheumatology (T.G.O.), Mayo Clinic, 200 1st St SW, Rochester, MN 55905.
出版信息
Radiology. 2019 May;291(2):479-484. doi: 10.1148/radiol.2019181729. Epub 2019 Mar 5.
Background Lung US surface wave elastography (SWE) can noninvasively quantify lung surface stiffness or fibrosis by evaluating the rate of surface wave propagation. Purpose To assess the utility of lung US SWE for evaluation of interstitial lung disease. Materials and Methods In this prospective study, lung US SWE was used to assess 91 participants (women, 51; men, 40; mean age ± standard deviation [SD], 62.4 years ± 12.9) with interstitial lung disease and 30 healthy subjects (women, 16; men, 14; mean age, 45.4 years ± 14.6) from February 2016 through May 2017. Severity of interstitial lung disease was graded as none (healthy lung [F0]), mild (F1), moderate (F2), or severe (F3) based on pulmonary function tests, high-resolution CT, and clinical assessments. We propagated surface waves on the lung through gentle mechanical excitation of the external chest wall and measured the lung surface wave speed with a US probe. Lung US SWE performance was assessed, and the optimal cutoff wave speed values for fibrosis grades F0 through F3 were determined with receiver operating characteristic (ROC) curve analysis. Results Lung US SWE had a sensitivity of 92% (95% confidence intervals [CI]: 84%, 96%; < .001) and a specificity of 89% (95% CI: 81%, 94%; < .001) for differentiating between healthy subjects (F0) and participants with any grade of interstitial lung disease (F1-F3). It had a sensitivity of 50% and a specificity of 81% for differentiating interstitial lung disease grades F0-F2 from F3. The sensitivity was 88% and the specificity was 97% for differentiating between F0 and F1. The highest area under the ROC curve (AUC) values were obtained at 200 Hz and ranged from 0.83 to 0.94 to distinguish between healthy subjects and study participants with any interstitial lung disease. Conclusion Lung US surface wave elastography may be adjunct to high-resolution CT for noninvasive evaluation of interstitial lung disease. © RSNA, 2019 See also the editorial by Verschakelen in this issue.
背景 肺部超声表面波弹性成像（SWE）可通过评估表面波传播速率来无创性地定量评估肺表面硬度或纤维化程度。目的 评估肺部超声 SWE 用于评估间质性肺疾病的效用。 材料与方法 本前瞻性研究使用肺部超声 SWE 评估了 91 名间质性肺疾病患者（女性 51 名，男性 40 名；平均年龄±标准差[SD]，62.4 岁±12.9 岁）和 30 名健康对照者（女性 16 名，男性 14 名；平均年龄，45.4 岁±14.6 岁）。根据肺功能检查、高分辨率 CT 和临床评估，将间质性肺疾病的严重程度分级为无（健康肺[F0]）、轻度（F1）、中度（F2）或重度（F3）。我们通过轻柔地机械激励胸壁来在肺部传播表面波，并使用 US 探头测量肺表面波速度。评估了肺部超声 SWE 的性能，并通过接收者操作特征（ROC）曲线分析确定用于纤维化分级 F0 至 F3 的最佳波速截断值。 结果 肺部超声 SWE 对区分健康对照者（F0）和任何程度间质性肺疾病患者（F1-F3）的敏感度为 92%（95%置信区间[CI]：84%，96%；<.001），特异度为 89%（95% CI：81%，94%；<.001）。其对区分间质性肺疾病 F0-F2 与 F3 的敏感度为 50%，特异度为 81%。F0 与 F1 之间的敏感度为 88%，特异度为 97%。在区分健康对照者与任何间质性肺疾病患者时，ROC 曲线下面积（AUC）最高值出现在 200 Hz，范围为 0.83 至 0.94。 结论 肺部超声表面波弹性成像可能有助于高分辨率 CT 对间质性肺疾病进行无创评估。 由 Verschakelen 为本刊撰写的述评见本期同一栏目。
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