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肺部超声在冠状病毒病(COVID-19)中的诊断准确性和预后价值

Diagnostic accuracy and prognostic value of lung ultrasound in coronavirus disease (COVID-19).

作者信息

Azadbakht Javid, Saffari Maryam, Talarie Hamidreza, Esfahani Mahsa Masjedi, Barzegar Mahdi

机构信息

Department of Radiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Pol J Radiol. 2022 Jul 18;87:e397-e408. doi: 10.5114/pjr.2022.118304. eCollection 2022.

Abstract

PURPOSE

This study aimed to assess the correlation between lung ultrasound (LUS) and computed tomography (CT) findings and the predictability of LUS scores to anticipate disease characteristics, lab data, clinical severity, and mortality in patients with COVID-19.

MATERIAL AND METHODS

Fifty consecutive hospitalized PCR-confirmed COVID-19 patients who underwent chest CT scan and LUS on the first day of admission were enrolled. The LUS score was calculated based on the presence, severity, and distribution of parenchymal abnormalities in 14 regions.

RESULTS

The participants' mean age was 54.60 ± 19.93 years, and 26 (52%) were female. All patients had CT and LUS findings typical of COVID-19. The mean value of CT and LUS severity scores were 11.80 ± 3.89 (ranging from 2 to 20) and 13.74 ± 6.43 (ranging from 1 to 29), respectively. The LUS score was significantly higher in females ( = 0.016), and patients with dyspnoea ( = 0.048), HTN ( = 0.034), immunodeficiency ( = 0.034), room air SpO ≤ 93 ( = 0.02), and pleural effusion ( = 0.036). LUS findings were strongly correlated with CT scan results regarding lesion type, distribution, and severity in a region-by-region fashion (92-100% agreement). An LUS score of 14 or higher was predictive of room air SpO ≤ 93 and ICU admission, while an LUS score ≥ 12 was predictive of death ( = 0.011, 0.023, and 0.003, respectively).

CONCLUSIONS

Our results suggested that LUS can be used as a valuable tool for detecting COVID-19 pneumonia and determining high-risk hospitalized patients, helping to triage and stratify high-risk patients, which waives the need to undertake irradiating chest CT and reduces the burden of overworked CT department staff.

摘要

目的

本研究旨在评估肺超声(LUS)与计算机断层扫描(CT)结果之间的相关性,以及LUS评分对预测新型冠状病毒肺炎(COVID-19)患者疾病特征、实验室数据、临床严重程度和死亡率的可预测性。

材料与方法

纳入50例连续住院的经聚合酶链反应(PCR)确诊的COVID-19患者,这些患者在入院第一天接受了胸部CT扫描和LUS检查。LUS评分基于14个区域实质异常的存在、严重程度和分布来计算。

结果

参与者的平均年龄为54.60±19.93岁,26例(52%)为女性。所有患者均有典型的COVID-19的CT和LUS表现。CT和LUS严重程度评分的平均值分别为11.80±3.89(范围为2至20)和13.74±6.43(范围为1至29)。女性(P = 0.016)、有呼吸困难的患者(P = 0.048)、高血压患者(P = 0.034)、免疫缺陷患者(P = 0.034)、室内空气下血氧饱和度(SpO₂)≤93的患者(P = 0.02)以及有胸腔积液的患者(P = 0.036)的LUS评分显著更高。LUS表现与CT扫描结果在病变类型、分布和严重程度方面逐区域高度相关(一致性为92 - 100%)。LUS评分14或更高可预测室内空气下SpO₂≤93和入住重症监护病房(ICU),而LUS评分≥12可预测死亡(P分别为0.011、0.023和0.003)。

结论

我们的结果表明,LUS可作为检测COVID-19肺炎和确定高危住院患者的有价值工具,有助于对高危患者进行分诊和分层,从而无需进行放射性胸部CT检查,并减轻CT科室工作人员的工作负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/334a/9373868/e1e0b92a4fbd/PJR-87-47545-g001.jpg

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