Pereira Rodrigo O L, Convissar David L, Montgomery Sean, Herbert James T, Reed Christopher R, Tang Hoang J, Bronshteyn Yuriy S
Department of Anesthesiology, Duke University School of Medicine;
Department of Anesthesiology, Massachusetts General Hospital.
J Vis Exp. 2023 Mar 3(193). doi: 10.3791/64722.
Consultative ultrasound performed by radiologists has traditionally not been used for imaging the lungs, as the lungs' air-filled nature normally prevents direct visualization of the lung parenchyma. When showing the lung parenchyma, ultrasound typically generates a number of non-anatomic artifacts. However, over the past several decades, these artifacts have been studied by diagnostic point-of-care ultrasound (POCUS) practitioners, who have identified findings that have value in narrowing the differential diagnoses of cardiopulmonary dysfunction. For instance, in patients presenting with dyspnea, lung POCUS is superior to chest radiography (CXR) for the diagnosis of pneumothorax, pulmonary edema, lung consolidations, and pleural effusions. Despite its known diagnostic value, the utilization of lung POCUS in clinical medicine remains variable, in part because training in this modality across hospitals remains inconsistent. To address this educational gap, this narrative review describes lung POCUS image acquisition in adults, including patient positioning, transducer selection, probe placement, acquisition sequence, and image optimization.
传统上，放射科医生进行的会诊超声检查并不用于肺部成像，因为肺部充满空气的特性通常会妨碍对肺实质的直接观察。在显示肺实质时，超声通常会产生一些非解剖学伪像。然而，在过去几十年里，这些伪像已被床旁诊断超声（POCUS）从业者研究，他们发现了一些在缩小心肺功能障碍鉴别诊断范围方面有价值的表现。例如，对于出现呼吸困难的患者，肺部POCUS在诊断气胸、肺水肿、肺实变和胸腔积液方面优于胸部X线摄影（CXR）。尽管其诊断价值已为人所知，但肺部POCUS在临床医学中的应用仍然存在差异，部分原因是各医院在这种检查方式上的培训仍不一致。为了弥补这一教育差距，本篇叙述性综述描述了成人肺部POCUS图像采集方法，包括患者体位、探头选择、探头放置、采集顺序和图像优化。
