Postgraduation Program in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
Rehabilitation Sciences Postgraduation Program, Augusto Motta University Center, Rio de Janeiro, Brazil.
J Ultrasound Med. 2021 Jul;40(7):1391-1399. doi: 10.1002/jum.15521. Epub 2020 Sep 30.
The aim of this study was to describe findings from lung ultrasound (LUS) and computed tomography (CT) in health professionals with coronavirus disease 2019 pneumonia and to evaluate the associations of the findings of both tests.
This cross-sectional observational study evaluated 45 health professionals who were initially seen in screening tents and had a diagnosis of coronavirus disease 2019 as confirmed by a reverse transcription polymerase chain reaction and lung involvement diagnosed by LUS. Subsequently, these individuals were admitted to the hospital, where chest CT was performed. Aeration scores were obtained for the LUS examinations based on the following findings: more than 2 B-lines, coalescent B-lines, and subpleural consolidations. A subjective assessment of the extent of lung disease on CT was performed on the basis of the percentage of lung parenchyma involvement as follows: 25% or less, 25% to 50%, and greater than 50%.
Regarding LUS signs, more than 2 B-lines, coalescent B-lines, and subpleural consolidations were present in 73.3%, 68.2%, and 24.4% of cases, respectively. The main findings on CT were ground glass opacities, a crazy-paving pattern, and consolidations (66.7%, 20%, and 20% of cases); 17.8% of cases had examinations without abnormalities. Patients with more than 2 B-lines on LUS had more ground glass opacity areas on CT (P = .0007), whereas patients with subpleural consolidations on LUS had more consolidations on CT (P < .0001). In addition, patients with higher LUS aeration scores had more extensive disease on CT (P < .0001).
Lung ultrasound can detect lung injury even in the presence of normal CT results. There are associations between the abnormalities detected by both methods, and a relationship also exists between LUS aeration scores and the disease extent on CT.
本研究旨在描述 COVID-19 肺炎患者的肺部超声(LUS)和计算机断层扫描(CT)检查结果,并评估两种检查结果的相关性。
这是一项横断面观察性研究,共纳入 45 名最初在筛查帐篷中就诊的卫生专业人员,他们的 COVID-19 诊断通过逆转录聚合酶链反应(RT-PCR)得到确认,肺部受累通过 LUS 诊断。随后,这些患者被收入医院进行胸部 CT 检查。根据以下发现对 LUS 检查的通气评分进行评估:存在多于 2 条 B 线、融合的 B 线和胸膜下实变。根据受累肺实质百分比,对 CT 上的肺部疾病严重程度进行主观评估,分为以下三种情况:受累 25%或更少、25%至 50%和大于 50%。
在 LUS 征象方面,分别有 73.3%、68.2%和 24.4%的患者存在多于 2 条 B 线、融合的 B 线和胸膜下实变。CT 的主要表现为磨玻璃影、铺路石征和实变(分别为 66.7%、20%和 20%的患者);17.8%的患者 CT 检查未见异常。在 LUS 上存在多于 2 条 B 线的患者在 CT 上的磨玻璃影面积更大(P =.0007),而在 LUS 上存在胸膜下实变的患者在 CT 上的实变面积更大(P <.0001)。此外,LUS 通气评分较高的患者在 CT 上的病变范围更广(P <.0001)。
即使 CT 结果正常,肺部超声也能检测到肺部损伤。两种方法检测到的异常之间存在相关性,LUS 通气评分与 CT 上的疾病严重程度之间也存在相关性。