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超声检查在渗出性胸腔积液诊断中的效果。

Efficacy of Ultrasonography in the Diagnosis of Transudative Pleural Fluids.

机构信息

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

出版信息

J Bronchology Interv Pulmonol. 2021 Apr 1;28(2):143-149. doi: 10.1097/LBR.0000000000000726.

Abstract

AIMS

We aimed to evaluate the efficacy of thoracic ultrasonography (USG) in diagnosis of pleural exudates and transudates using pleural thickness (PT) measurement.

PATIENTS AND METHODS

Patients who underwent investigations for pleural fluid between January 2018 and May 2018 were included in this prospective study. The patients were evaluated using radiologic imaging modalities to detect pleural fluid, and PT was measured using thoracic USG. The patients were then divided into 2 groups according to Light's criteria as transudative pleural fluid (TPF) and exudative pleural fluid (EPF), and the results were compared between the groups.

RESULTS

A total of 73 patients were included in the study. The mean age was 62±15.1 years. Forty-eight patients (65.8%) had EPF and 25 (34.2%) had TPF. Thoracic USG revealed a mean PT of 0.3±0.1 cm in the TPF group and 0.6±0.3 cm in the EPF group (P<0.001). The optimal cut-off value for PT was 0.2 cm in the TPF group. The sensitivity and specificity of thoracic USG were calculated as 87.5% and 56%, respectively.

CONCLUSION

The measurement of PT using thoracic USG in this study has a high sensitivity but low specificity for identifying transudates from exudates. This approach may be useful in patients who refuse thoracentesis or have a contraindication for the procedure, and in emergency and intensive care unit settings. We recommend further studies to determine the efficacy of thoracic USG studies in patients with pleural fluids.

摘要

目的

我们旨在评估通过胸腔超声(USG)测量胸腔积液厚度(PT)来诊断胸腔渗出液和漏出液的效果。

患者与方法

本前瞻性研究纳入了 2018 年 1 月至 2018 年 5 月间接受胸腔积液检查的患者。使用放射影像学方法评估患者,使用胸腔 USG 测量 PT。根据 Light 标准,将患者分为渗出性胸腔积液(EPF)和漏出性胸腔积液(TPF)两组,并对两组结果进行比较。

结果

共有 73 例患者纳入研究。平均年龄为 62±15.1 岁。48 例(65.8%)为 EPF,25 例(34.2%)为 TPF。胸腔 USG 显示 TPF 组的平均 PT 为 0.3±0.1cm,EPF 组为 0.6±0.3cm(P<0.001)。PT 的最佳截断值为 0.2cm 时,TPF 组的敏感度和特异度分别为 87.5%和 56%。

结论

本研究中胸腔 USG 测量 PT 对识别渗出液和漏出液具有较高的敏感度和较低的特异度。这种方法可能对拒绝或有禁忌行胸腔穿刺术的患者以及在急诊和重症监护病房环境中有用。我们建议进一步研究以确定胸腔 USG 对胸腔积液患者的效果。

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