Radulova Petya, Vakrilova Liliya, Hitrova-Nikolova Stanislava, Dimitrova Violeta
Department of Obstetrics and Gynecology, Medical University of Sofia, Sofia, Bulgaria.
Neonatology Clinic, University Hospital of Obstetrics and Gynecology "Maichin Dom", Sofia, Bulgaria.
J Clin Ultrasound. 2022 Nov;50(9):1322-1327. doi: 10.1002/jcu.23207. Epub 2022 Mar 30.
Lung ultrasound (LUS) is a widely used technique in neonates to diagnose a lot of acute diseases. However, its role in the diagnosis of chronic lung conditions is still to be evaluated. We aimed to describe the changes in ultrasound images as well as the appearance of lung consolidations (LC) in very low birth weight (VLBW) infants with and without bronchopulmonary dysplasia (BPD).
For a period of 2 years we prospectively examined 124 VLBW infants, divided into two main groups: below 28 gestational weeks with two subgroups-BPD (moderate and severe) and non-BPD, and 28-32 gestational weeks with two subgroups-BPD (moderate and severe) and non-BPD group. We performed weekly LUS until 36 weeks' postmenstrual age (PMA). On the seventh postnatal day, we calculated the LUS score as a semiquantitative score that represents the aeration (0-3) in three different areas (upper anterior, lower anterior, lateral) of each lung.
We performed around 750 LUS exams. The BPD groups had LUS scores above 8 on the seventh day, p < 0.001. The number of LC was higher in the BPD groups 14 (3-45) than in the mild or non-BPD groups 2.5 (0-6), p < 0.001, and the difference was significant for the period between 1 week and 1 month after birth, p = 0.001. In the BPD group <28 weeks' PMA, LC appeared equally in the anterior, lateral, and posterior fields, while in the BPD group 28-32 weeks' PMA, LC are more typical for the anterior-lateral fields.
Serial LUS exams and identification of LC could be early predictors of moderate and severe forms of BPD. LUS score >8 on the seventh postnatal day is an early predictor of severe BPD. LC in more lung fields are typical for the severe forms of the disease.
肺部超声（LUS）是新生儿中广泛用于诊断多种急性疾病的技术。然而，其在慢性肺部疾病诊断中的作用仍有待评估。我们旨在描述极低出生体重（VLBW）且患有和未患有支气管肺发育不良（BPD）的婴儿的超声图像变化以及肺实变（LC）的表现。
在2年的时间里，我们前瞻性地检查了124例VLBW婴儿，分为两个主要组：妊娠28周以下，有两个亚组——BPD（中度和重度）和非BPD组，以及妊娠28 - 32周，有两个亚组——BPD（中度和重度）和非BPD组。我们每周进行一次LUS检查，直至孕龄36周（PMA）。在出生后第7天，我们计算LUS评分，作为一种半定量评分，代表每个肺的三个不同区域（上前部、下前部、外侧）的通气情况（0 - 3分）。
我们进行了约750次LUS检查。BPD组在第7天的LUS评分高于8分，p < 0.001。BPD组的LC数量为14（3 - 45），高于轻度或非BPD组的2.5（0 - 6），p < 0.001，且在出生后1周和1个月之间差异显著，p = 0.001。在PMA < 28周的BPD组中，LC在前部、外侧和后部区域出现的情况相同，而在PMA为28 - 32周的BPD组中，LC在前外侧区域更为典型。
连续的LUS检查和LC的识别可能是中度和重度BPD的早期预测指标。出生后第7天LUS评分>8是重度BPD的早期预测指标。更多肺野出现LC是该疾病严重形式的典型表现。
