Radzina Maija, Biederer Jürgen
Riga Stradins University, Radiology Research Laboratory, Riga, Latvia.
Paula Stradina Clinical University Hospital, Diagnostic Radiology Institute, Riga, Latvia.
Rofo. 2019 Oct;191(10):909-923. doi: 10.1055/a-0881-3179. Epub 2019 Apr 4.
High diagnostic accuracy, increasing clinical experience and technical improvements are good reasons to consider lung ultrasound (US) for the assessment of pleural and pulmonary diseases. In the emergency room and in intensive care, it is well acknowledged, but application in other settings is rare. The aim of this review is to update potential users in general radiology about the diagnostic scope of lung US and to encourage more frequent use of this generally underestimated lung imaging modality.
Literature review was done independently by the two authors in MEDLINE (via PubMed) covering a time span from 2002 until 2017 using free text and Medical Subject Headings/MeSH. Article selection for the bibliography was based on consensus according to relevance and evidence.
The technical prerequisites include a standard ultrasound unit with a suitable transducer. Pleural effusion and pneumothorax, atelectasis, interstitial edema, pneumonia, exacerbated chronic obstructive pulmonary disease/asthma and pulmonary embolism can be distinguished by particular ultrasound signs, artifacts and their combinations. A highly standardized selection of access points and terminology for the description of imaging findings contributes to high diagnostic accuracy even in challenging patients and settings. Besides the assessment of acute respiratory failure in the emergency room, lung US may be used for monitoring interstitial fluid accumulation in volume therapy and for the diagnosis of pneumonia or the assessment of pleural effusion and pleurisy in a routine outpatient setting. Last but not least, the increasing concerns about medical radiation exposure warrant a more extensive use of this sometimes underestimated modality as a cost-, time- and radiation-saving alternative or valuable adjunct to the standard imaging modalities.
· Lung US is a safe, quick and readily available method with options for dynamic imaging of respiratory function.. · Proper selection of technical parameters customized to the clinical question and standardized terminology for the precise description and interpretation of the imaging signs regarding patient history determine its diagnostic accuracy.. · In dyspnea lung US differentiates pneumothorax, lung edema, pneumonia, pulmonary embolism, atelectasis and pleural effusion.. · In intensive care, lung US allows monitoring of lung ventilation and fluid administration.. · It saves radiation exposure in serial follow-up, in pregnancy and pediatric radiology..
· Radzina M, Biederer J, Ultrasonography of the Lung. Fortschr Röntgenstr 2019; 191: 909 - 923.
高诊断准确性、不断增加的临床经验以及技术进步是考虑使用肺部超声（US）评估胸膜和肺部疾病的充分理由。在急诊室和重症监护中，这一点已得到广泛认可，但在其他环境中的应用却很少见。本综述的目的是向普通放射学领域的潜在用户介绍肺部超声的诊断范围，并鼓励更频繁地使用这种通常被低估的肺部成像方式。
两位作者独立在MEDLINE（通过PubMed）上进行文献综述，涵盖2002年至2017年的时间段，使用自由文本和医学主题词/MeSH。参考文献的文章选择基于相关性和证据的共识。
技术前提包括配备合适换能器的标准超声设备。胸腔积液和气胸、肺不张、间质性水肿、肺炎、慢性阻塞性肺疾病/哮喘急性加重以及肺栓塞可通过特定的超声征象、伪像及其组合来区分。高度标准化地选择检查点和描述影像学表现的术语，即使在具有挑战性的患者和环境中也有助于提高诊断准确性。除了在急诊室评估急性呼吸衰竭外，肺部超声还可用于在容量治疗中监测间质液积聚，以及在常规门诊环境中诊断肺炎或评估胸腔积液和胸膜炎。最后但同样重要的是，对医疗辐射暴露的日益关注促使更广泛地使用这种有时被低估的方式，作为一种节省成本、时间和辐射的替代方法或标准成像方式的有价值辅助手段。
·肺部超声是一种安全、快速且易于获得的方法，可对呼吸功能进行动态成像。·根据临床问题正确选择技术参数，并使用标准化术语准确描述和解释与患者病史相关的影像学征象，决定了其诊断准确性。·在呼吸困难时，肺部超声可区分气胸、肺水肿、肺炎、肺栓塞、肺不张和胸腔积液。·在重症监护中，肺部超声可用于监测肺通气和液体输注。·在系列随访、妊娠和儿科放射学中，它可节省辐射暴露。
·Radzina M, Biederer J, 肺部超声。Fortschr Röntgenstr 2019; 191: 909 - 923。
