Department of Paediatrics, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Department of Neonatology and Neonatal Intensive Care Unit, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Pediatr Pulmonol. 2023 Jan;58(1):122-129. doi: 10.1002/ppul.26168. Epub 2022 Oct 6.
Whether lung ultrasound (LUS) can be used for pathogenic diagnosis remains controversial. This study was conducted to clarify whether ultrasound has diagnostic value for etiology.
A total of 135 neonatal pneumonia patients with an identified pathogen were enrolled from the newborn intensive care units of 10 tertiary hospitals in China. The study ran from November 2020 to December 2021. The infants were divided into various groups according to pathogens, time of infection, gestational age, and disease severity. The distribution of pleural line abnormalities, B-line signs, and pulmonary consolidation, as well as the incidence of air bronchogram and pleural effusion based on LUS, were compared between these groups.
There were significant differences in pulmonary consolidation. The sensitivity and specificity of the diagnosis of severe pneumonia based on the extent of pulmonary consolidation were 83.3% and 85.2%, respectively. The area under the receiver operating characteristic curve for the identification of mild or severe pneumonia based on the distribution of pulmonary consolidation was 0.776.
LUS has good performance in diagnosing and differentiating the severity of neonatal pneumonia but cannot be used for pathogenic identification in the early stages of pneumonia.
肺部超声(LUS)是否可用于病因诊断仍存在争议。本研究旨在阐明超声对病因是否具有诊断价值。
本研究纳入了中国 10 家三级医院新生儿重症监护病房的 135 例已明确病原体的新生儿肺炎患者。研究时间为 2020 年 11 月至 2021 年 12 月。根据病原体、感染时间、胎龄和疾病严重程度,将患儿分为不同组。比较各组 LUS 下的肋胸膜线异常、B 线征象和肺实变以及空气支气管征和胸腔积液的发生率。
肺实变存在显著差异。基于肺实变范围,严重肺炎诊断的敏感度和特异度分别为 83.3%和 85.2%。基于肺实变分布识别轻或重症肺炎的受试者工作特征曲线下面积为 0.776。
LUS 在诊断和区分新生儿肺炎严重程度方面具有良好的性能,但不能用于肺炎早期的病因识别。