Feng X Y, Tao X W, Zeng L K, Wang W Q, Li G
Department of Ultrasound Imaging, Wuhan Children's Hospital of Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430016, China.
Department of Neonatology, Wuhan Children's Hospital of Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430016, China.
Zhonghua Er Ke Za Zhi. 2020 May 2;58(5):347-350. doi: 10.3760/cma.j.cn112140-20200228-00154.
To investigate the application of pulmonary ultrasound in the diagnosis of neonatal COVID-19. In this retrospective study, the clinical data of 5 infants, who were admitted to the Department of Neonatology in Wuhan Children's Hospital from 31(st) January to 25(th) February 2020, were collected. Bedsides pulmondary ultrasound was conducted on admission, during the hospitalization, and before discharge, the result were compared with the chest X-ray or CT done at the same time. Among the 5 cases who aged 1-18 days, 3 were male. The main clinical manifestations were respiratory and gastrointestinal symptoms. The pulmonary ultrasonography on admission showed abnormal pleural line and pulmonary edema of different severity in all 5 cases, presented as increase and fusion of B-line, and pulmonary interstitial syndrome; among them, one case also had a small-range consolidation. The chest CT on admission showed no obvious parenchymal infiltration in 2 cases, small strip or patchy high-density shadow in 2 cases, and ground glass change in one case. The re-examination of ultrosound during the hospitalization and at discharge showed improvement in all cases and were consistent with the chest X-ray taken at the same time. The main changes on the pulmonary ultrasonography in neonates with COVID-19 pneumonia are increase and fusion of B-line, abnormal pleural line, and alveolar interstitial syndrome, and may coexist with small range of pulmonary consolidation. The sensitivity of pulmonary ultrasound is higher than that of chest X-ray and CT in the diagnosis of pulmonary edema, and could be used in monitoring and evaluation of the disease.
探讨肺部超声在新生儿新型冠状病毒肺炎(COVID-19)诊断中的应用。在这项回顾性研究中,收集了2020年1月31日至2月25日入住武汉儿童医院新生儿科的5例婴儿的临床资料。入院时、住院期间及出院前均进行床旁肺部超声检查,并将结果与同时进行的胸部X线或CT检查结果进行比较。5例患儿年龄为1 - 18天,其中男性3例。主要临床表现为呼吸和胃肠道症状。入院时肺部超声检查显示5例患儿均有胸膜线异常及不同程度的肺水肿,表现为B线增多、融合及肺间质综合征;其中1例还伴有小范围实变。入院时胸部CT检查显示,2例无明显实质浸润,2例有小条索状或斑片状高密度影,1例有磨玻璃样改变。住院期间及出院时超声复查显示所有病例均有改善,且与同时进行的胸部X线检查结果一致。COVID-19肺炎新生儿肺部超声的主要表现为B线增多、融合,胸膜线异常及肺泡间质综合征,可能合并小范围肺实变。肺部超声在诊断肺水肿方面的敏感性高于胸部X线和CT,可用于疾病的监测和评估。