Department of Cardiac Ultrasound, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei.
Department of Ultrasound.
Medicine (Baltimore). 2021 Mar 26;100(12):e25217. doi: 10.1097/MD.0000000000025217.
Lung ultrasound (LUS) has recently been used to identify interstitial lung disease (ILD). However, data on the role of LUS in the detection of ILD remain limited. The aim of this study was to investigate the diagnostic value of LUS compared with high-resolution computed tomography (HRCT) in patients with ILD.The retrospective study was carried out by reviewing the medical records of patients with respiratory signs and symptoms discharged from the respiratory ward. Only patients with suspected ILD who underwent HRCT and LUS within a week were selected. ILD was identified with a semi-quantitative score of B-lines >5 and a Warrick score >0 points. The endpoints of LUS in diagnosing ILD (i.e., sensitivity, specificity, positive likelihood ratio [PLR], negative likelihood ratio [NLR], positive predictive value [PPV], and negative predictive value [NPV], and receiver operating characteristic [ROC] curve) was compared with that of HRCT. The reference standard used for the diagnosis of ILD was based on history, clinical findings and examination, and laboratory and instrumental tests, including pulmonary function tests, lung histopathology, and HRCT (without LUS findings).The final clinical diagnosis of ILD was 55 in 66 patients with suspected ILD. HRCT was positive in 55 patients, whereas LUS detected ILD in 51 patients. Four patients with negative LUS findings were positive on HRCT. The results showed 93% sensitivity, 73% specificity, 3.40 PLR, 0.10 NLR, 94% PPV, and 67% NPV for LUS, whereas 100% sensitivity, 82% specificity, 5.49 PLR, 0.01 NLR, 97% PPV, and 100% NPV for HRCT. Comparison of the 2 ROC curves revealed significant difference in the diagnostic value of the 2 methods for the diagnosis of ILD (P = .048).Our results indicated that LUS is a useful technique to identify ILD. Considering its non-radiation, portable and non-invasive advantages, LUS should be recommended as a valuable screening tool in patients with suspected ILD.
肺部超声（LUS）最近已被用于识别间质性肺疾病（ILD）。然而，关于 LUS 在 ILD 检测中的作用的数据仍然有限。本研究旨在探讨 LUS 与高分辨率计算机断层扫描（HRCT）在 ILD 患者中的诊断价值。
该回顾性研究通过审查呼吸病房出院患者的病历进行。仅选择了在一周内接受 HRCT 和 LUS 检查的疑似 ILD 患者。ILD 通过 B 线>5 分和 Warrick 评分>0 分的半定量评分来确定。LUS 诊断 ILD 的终点（即敏感性、特异性、阳性似然比[PLR]、阴性似然比[NLR]、阳性预测值[PPV]和阴性预测值[NPV]以及受试者工作特征[ROC]曲线）与 HRCT 进行了比较。ILD 的诊断参考标准基于病史、临床发现和检查以及实验室和仪器检查，包括肺功能检查、肺组织病理学和 HRCT（无 LUS 发现）。
在 66 例疑似 ILD 患者中，最终临床诊断为 55 例。HRCT 在 55 例患者中呈阳性，而 LUS 在 51 例患者中检测到 ILD。4 例 LUS 阴性发现的患者在 HRCT 中呈阳性。结果显示，LUS 的敏感性为 93%，特异性为 73%，阳性似然比为 3.40，阴性似然比为 0.10，阳性预测值为 94%，阴性预测值为 67%，而 HRCT 的敏感性为 100%，特异性为 82%，阳性似然比为 5.49，阴性似然比为 0.01，阳性预测值为 97%，阴性预测值为 100%。两种 ROC 曲线的比较显示，两种方法对 ILD 的诊断价值存在显著差异（P=0.048）。
我们的结果表明，LUS 是一种识别 ILD 的有用技术。考虑到其无辐射、便携和非侵入性的优势，LUS 应被推荐为疑似 ILD 患者的有价值的筛查工具。
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