肺部超声中垂直伪像随频率变化的临床影响
Clinical Impact of Vertical Artifacts Changing with Frequency in Lung Ultrasound.
作者信息
Buda Natalia, Skoczylas Agnieszka, Demi Marcello, Wojteczek Anna, Cylwik Jolanta, Soldati Gino
机构信息
Department of Internal Medicine, Connective Tissue Diseases and Geriatric, Medical University of Gdansk, 80-952 Gdansk, Poland.
Department of Geriatrics, National Institute of Geriatrics Rheumatology and Rehabilitation, 02-637 Warsaw, Poland.
出版信息
Diagnostics (Basel). 2021 Feb 26;11(3):401. doi: 10.3390/diagnostics11030401.
BACKGROUND
This study concerns the application of lung ultrasound (LUS) for the evaluation of the significance of vertical artifact changes with frequency and pleural line abnormalities in differentiating pulmonary edema from pulmonary fibrosis.
STUDY DESIGN AND METHODS
The study was designed as a diagnostic test. Having qualified patients for the study, an ultrasound examination was performed, consistent with a predetermined protocol, and employing convex and linear transducers. We investigated the possibility of B-line artifact conversion depending on the set frequency (2 MHz and 6 MHz), and examined pleural line abnormalities.
RESULTS
The study group comprised 32 patients with interstitial lung disease (ILD) (and fibrosis) and 30 patients with pulmonary edema. In total, 1941 cineloops were obtained from both groups and analyzed. The employment of both types of transducers (linear and convex) was most effective (specificity 91%, specificity 97%, positive predictive value (PPV) 97%, negative predictive value (NPV) 91%, LR(+) 27,19, LR(-) 0.097, area under curve (AUC) = 0.936, = 7 × 10).
INTERPRETATION
The best accuracy in differentiating the etiology of B-line artifacts was obtained with the use of both types of transducers (linear and convex), complemented with the observation of the conversion of B-line artifacts to Z-line.
背景
本研究关注肺部超声（LUS）在评估垂直伪像随频率变化的意义以及胸膜线异常在鉴别肺水肿与肺纤维化中的应用。
研究设计与方法
本研究设计为一项诊断试验。在使患者符合研究条件后，按照预定方案进行超声检查，并使用凸阵探头和线阵探头。我们研究了B线伪像根据设定频率（2兆赫和6兆赫）转换的可能性，并检查了胸膜线异常情况。
结果
研究组包括32例间质性肺疾病（ILD）（及纤维化）患者和30例肺水肿患者。两组共获得1941个动态图像并进行分析。使用两种类型的探头（线阵和凸阵）最为有效（敏感度91%，特异度97%，阳性预测值（PPV）97%，阴性预测值（NPV）91%，阳性似然比（LR(+)）27.19，阴性似然比（LR(-)）0.097，曲线下面积（AUC）=0.936，P = 7×10）。
解读
使用两种类型的探头（线阵和凸阵），并辅以观察B线伪像向Z线的转换，在鉴别B线伪像病因方面可获得最佳准确性。
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