Tomicic Vinko, Cornejo Rodrigo
Jefe Unidad de Cuidados Intensivos Respiratorios, Clínica Indisa, Universidad Andres Bello, Santiago, Chile.
Jefe Unidad de Pacientes Críticos, Departamento de Medicina, Hospital Clínico Universidad de Chile, Chile.
J Thorac Dis. 2019 Jul;11(7):3122-3135. doi: 10.21037/jtd.2019.06.27.
In recent years there has been substantial progress in the imaging evaluation of patients with lung disease requiring mechanical ventilatory assistance. This has been demonstrated by the inclusion of pulmonary ultrasound, positron emission tomography, electrical impedance tomography (EIT), and magnetic resonance imaging (MRI). The EIT uses electric current to evaluate the distribution of alternating current conductivity within the thoracic cavity. The advantage of the latter is that it is non-invasive, bedside radiation-free functional imaging modality for continuous monitoring of lung ventilation and perfusion. EIT can detect recruitment or derecruitment, overdistension, variation of poorly ventilated lung units (silent spaces), and pendelluft phenomenon in spontaneously breathing patients. In addition, the regional expiratory time constants have been recently explored.
近年来,在对需要机械通气辅助的肺部疾病患者的影像评估方面取得了重大进展。这已通过纳入肺部超声、正电子发射断层扫描、电阻抗断层扫描(EIT)和磁共振成像(MRI)得以证明。EIT利用电流来评估胸腔内交流电导率的分布。后者的优点在于它是一种非侵入性的、床边无辐射的功能成像方式,可用于持续监测肺通气和灌注。EIT能够检测自主呼吸患者的肺复张或肺不张、过度膨胀、通气不良肺单元(寂静区)的变化以及钟摆呼吸现象。此外,最近还对区域呼气时间常数进行了探索。