Tamburrini Stefania, Consoli Letizia, Garrone Marco, Sfuncia Giuseppe, Lugarà Marina, Coppola Maria Gabriella, Piccirillo Miryam, Toto Roberta, Stella Salvatore Massimo, Sofia Soccorsa, Scuderi Mario, Catalano Orlando
Department of Radiology, Ospedale del Mare-Asl NA1 Centro, Via Enrico Russo, 11, 80147 Napoli, Italy.
Advanced Emergency Ultrasound SIUMB School, 80147 Naples, Italy.
Tomography. 2022 Mar 15;8(2):798-814. doi: 10.3390/tomography8020066.
A key issue in abdominal US is the assessment of fluid, which is usually anechoic, thus appearing "black". Our approach focuses on searching for fluid in non-traumatic patients, providing a new, simplified method for point-of-care US (POCUS).
Fluid assessment is based on a three-step analysis that we can thus summarize. 1. Look for black where it should not be. This means searching for effusions or collections. 2. Check if black is too much. This means evaluating anatomical landmarks where fluid should normally be present but may be abnormally abundant. 3. Look for black that is not clearly black. This means evaluating fluid aspects, whether wholly anechoic or not (suggesting heterogeneous or corpusculated fluid).
Using this simple method focused on US fluid presence and appearance should help clinicians to make a timely diagnosis. Although our simplified, systematic algorithm of POCUS may identify abnormalities; this usually entails a second-level imaging. An accurate knowledge of the physio-pathological and anatomical ultrasound bases remains essential in applying this algorithm.
The black pattern approach in non -traumatic emergencies may be applied to a broad spectrum of abnormalities. It may represent a valuable aid for emergency physicians, especially if inexperienced, involved in a variety of non-traumatic scenarios. It may also be a simple and effective teaching aid for US beginners.
腹部超声检查中的一个关键问题是对液体的评估，液体通常是无回声的，因此呈现“黑色”。我们的方法专注于在非创伤性患者中寻找液体，为床旁超声检查（POCUS）提供了一种新的、简化的方法。
液体评估基于我们可以总结的三步分析。1. 在不该出现黑色的地方寻找黑色。这意味着寻找积液或液性聚集。2. 检查黑色是否过多。这意味着评估正常情况下应该有液体但可能异常增多的解剖标志。3. 寻找并非明显黑色的黑色。这意味着评估液体的特征，无论是否完全无回声（提示液体不均匀或有细胞成分）。
使用这种专注于超声液体存在和外观的简单方法应有助于临床医生及时做出诊断。尽管我们简化的、系统的床旁超声检查算法可能识别出异常；但这通常需要二级成像。在应用此算法时，对生理病理和解剖超声基础的准确了解仍然至关重要。
非创伤性紧急情况中的黑色模式方法可应用于广泛的异常情况。它可能对急诊医生，尤其是经验不足、参与各种非创伤性场景的急诊医生有很大帮助。它也可能是超声初学者简单而有效的教学工具。
