Barner Anna, Burian Egon, Simon Alexander, Castillo Katty, Waschulzik Birgit, Braren Rickmer, Heemann Uwe, Osterwalder Joseph, Spiel Alexander, Heim Markus, Stock Konrad Friedrich
Department of Nephrology, School of Medicine, Technical University of Munich, Munich, Germany.
Department of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, Munich, Germany.
Ultraschall Med. 2023 Oct;44(5):e248-e256. doi: 10.1055/a-2013-8045. Epub 2023 Jan 16.
This prospective two-centre study investigated localisation-dependent lesion patterns in COVID-19 with standard lung ultrasonography (LUS) and their relationship with thoracic computed tomography (CT) and clinical parameters.
Between April 2020 and April 2021, 52 SARS-CoV-2-positive patients in two hospitals were examined by means of LUS for "B-lines", fragmented pleura, consolidation and air bronchogram in 12 lung regions and for pleural effusions. A newly developed LUS score based on the number of features present was correlated with clinical parameters (respiration, laboratory parameters) and the CT and analysed with respect to the 30- and 60-day outcome. All patients were offered an outpatient LUS follow-up.
The LUS and CT showed a bilateral, partially posteriorly accentuated lesion distribution pattern. 294/323 (91%) of CT-detected lesions were pleural. The LUS score showed an association with respiratory status and C-reactive protein; the correlation with the CT score was weak (Spearman's rho = 0.339, p < 0.001). High LUS scores on admission were also observed in patients who were discharged within 30 days. LUS during follow-up showed predominantly declining LUS scores.
The LUS score reflected the clinical condition of the patients. No conclusion could be made on the prognostic value of the LUS, because of the low event rate. The LUS and CT score showed no sufficient correlation. This is probably due to different physical principles, which is why LUS could be of complementary value.
本前瞻性双中心研究采用标准肺部超声（LUS）研究了新型冠状病毒肺炎（COVID-19）中定位依赖性病变模式及其与胸部计算机断层扫描（CT）和临床参数的关系。
2020年4月至2021年4月期间，对两家医院的52例严重急性呼吸综合征冠状病毒2（SARS-CoV-2）阳性患者进行了LUS检查，观察12个肺区的“B线”、胸膜破碎、实变和气支气管征以及胸腔积液情况。基于所出现特征数量新开发的LUS评分与临床参数（呼吸、实验室参数）和CT相关，并分析其30天和60天的预后情况。所有患者均接受门诊LUS随访。
LUS和CT显示双侧、部分后部加重的病变分布模式。CT检测到的病变中294/323（91%）为胸膜病变。LUS评分与呼吸状态和C反应蛋白相关；与CT评分的相关性较弱（Spearman等级相关系数=0.339，p<0.001）。30天内出院的患者入院时LUS评分也较高。随访期间的LUS显示LUS评分主要呈下降趋势。
LUS评分反映了患者的临床状况。由于事件发生率低，无法得出LUS预后价值的结论。LUS和CT评分没有充分的相关性。这可能是由于物理原理不同，这就是为什么LUS可能具有互补价值。
