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结节病肺实质受累的超声评估。

Ultrasonographic evaluation of lung parenchyma involvement in sarcoidosis.

作者信息

Doğan Coşkun, Kıral Nesrin, Parmaksız Elif Torun, Çağlayan Benan, Sağmen Seda Beyhan, Salepçi Banu, Fidan Ali, Cömert Sevda Şener

机构信息

Department of Chest Diseases, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Istanbul, Turkey.

Department Of Chest Diseases, Koç University, Istanbul, Turkey.

出版信息

Sarcoidosis Vasc Diffuse Lung Dis. 2019;36(2):130-140. doi: 10.36141/svdld.v36i2.7312. Epub 2019 May 1.

Abstract

PURPOSE

To use ultrasonography (USG) for the evaluation of lung parenchyma in patients with sarcoidosis, andto compare the USG findings with the results of a high-resolution computerized tomography (HRCT) and pulmonary function test-carbon monoxide diffusion test (PFT-DLCO), which are commonly used methods in the evaluation of parenchymal involvement in sarcoidosis.

MATERIAL AND METHODS

Patients with sarcoidosis and healthy controls were enrolled in the study between January 2015 and December 2017. The clinical findings, HRCT and PFT-DLCO results of all subjects were recorded, and USG findings and comet tail artifact (CTA) measurements were recorded by another pulmonologist. The USG, HRCT and SFT-DLCO findings were compared between the two groups. Based on the findings of theclinical-radiologic investigations and PFT-DLCO, as the current gold standard in diagnosis, the sensitivity and specificity of USG in demonstrating lung parenchyma involvement in sarcoidosis patients were estimated.

FINDINGS

The sarcoidosis group consisted of 79 patients and the control group included 34 subjects. The mean number of CTAs in the sarcoidosis and control groups was 33.4 and 25, respectively (p=0.001). In the sarcoidosis group, the number of CTAs in patients with DLCO% <80 and ≥80% was 37.4 and 29.7, respectively (p=0.011), and a negative correlation was identified between the number of CTAs and DLCO% (p=0.019 r=-0.267). The mean number of CTAs in patients with and without parenchymal involvement in HRCT was 36 and 25.5, respectively (p=0.001). The number of CTAs in the patients with sarcoidosis with a normal DLCO% value (≥80%) was higher than in the control group (p=0.014). The diagnostic sensitivity and specificity of thoracic USG were found to be 76% and 53%, respectively.

CONCLUSION

The number of CTAs in patients with sarcoidosis was higher than that of the healthy controls. The number of CTAs in patients with sarcoidosis with parenchymal involvement in HRCT and/or a low DLCO (<80%) was also elevated. Thoracic USG has a high sensitivity (76%) in demonstrating parenchymal involvement in patients with sarcoidosis.

摘要

目的

运用超声检查(USG)评估结节病患者的肺实质,并将USG检查结果与高分辨率计算机断层扫描(HRCT)及肺功能测试 - 一氧化碳弥散试验(PFT - DLCO)的结果进行比较,HRCT和PFT - DLCO是评估结节病实质受累情况常用的方法。

材料与方法

2015年1月至2017年12月期间纳入结节病患者及健康对照者进行研究。记录所有受试者的临床症状、HRCT及PFT - DLCO结果,另一位肺科医生记录USG检查结果及彗尾伪像(CTA)测量值。比较两组的USG、HRCT及SFT - DLCO检查结果。基于临床放射学检查及PFT - DLCO(作为目前诊断的金标准)的结果,评估USG在显示结节病患者肺实质受累方面的敏感性和特异性。

结果

结节病组有79例患者,对照组有34例受试者。结节病组和对照组的CTA平均数量分别为33.4和25(p = 0.001)。在结节病组中,DLCO%<80%和≥80%的患者CTA数量分别为37.4和29.7(p = 0.011),且CTA数量与DLCO%之间存在负相关(p = 0.019,r = -0.267)。HRCT显示有和无实质受累的结节病患者的CTA平均数量分别为36和25.5(p = 0.001)。DLCO%值正常(≥80%)的结节病患者的CTA数量高于对照组(p = 0.014)。发现胸部USG的诊断敏感性和特异性分别为76%和53%。

结论

结节病患者的CTA数量高于健康对照组。HRCT显示有实质受累和/或DLCO较低(<80%)的结节病患者的CTA数量也升高。胸部USG在显示结节病患者实质受累方面具有较高的敏感性(76%)。

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