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诊断与心力衰竭相关的胸部放射影像、肺部超声和胸部计算机断层扫描中的肺部异常。

Diagnosing Lung Abnormalities Related to Heart Failure in Chest Radiogram, Lung Ultrasound and Thoracic Computed Tomography.

机构信息

Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-091 Warsaw, Poland.

Students' Research Group 'Alveolus', Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-091 Warsaw, Poland.

出版信息

Adv Respir Med. 2023 Feb 23;91(2):103-122. doi: 10.3390/arm91020010.

Abstract

Heart failure (HF) is a multidisciplinary disease affecting almost 1-2% of the adult population worldwide. Symptoms most frequently reported by patients suffering from HF include dyspnoea, cough or exercise intolerance, which is equally often observed in many pulmonary diseases. The spectrum of lung changes related to HF is wide. The knowledge of different types of these abnormalities is essential to distinguish patients with HF from patients with lung diseases or both disorders and thus avoid unnecessary diagnostics or therapies. In this review, we aimed to summarise recent research concerning the spectrum of lung abnormalities related to HF in three frequently used lung imaging techniques: chest X-ray (CXR), lung ultrasound (LUS) and chest computed tomography (CT). We discussed the most prevalent abnormalities in the above-mentioned investigations in the context of consecutive pathophysiological stages identified in HF: (i) redistribution, (ii) interstitial oedema, and (iii) alveolar oedema. Finally, we compared the utility of these imaging tools in the clinical setting. In conclusion, we consider LUS the most useful and promising imaging technique due to its high sensitivity, repeatability and accessibility. However, the value of CXR and chest CT is their potential for establishing a differential diagnosis.

摘要

心力衰竭(HF)是一种多学科疾病,影响着全球近 1-2%的成年人。HF 患者最常报告的症状包括呼吸困难、咳嗽或运动耐量下降,而这些症状在许多肺部疾病中也同样常见。与 HF 相关的肺部变化范围很广。了解这些异常的不同类型对于将 HF 患者与肺部疾病患者或两种疾病患者区分开来至关重要,从而避免不必要的诊断或治疗。在本次综述中,我们旨在总结与 HF 相关的肺部异常的最新研究,涉及三种常用的肺部成像技术:胸部 X 线(CXR)、肺部超声(LUS)和胸部计算机断层扫描(CT)。我们根据 HF 中确定的连续病理生理阶段讨论了上述研究中最常见的异常:(i)再分布,(ii)间质水肿,和(iii)肺泡水肿。最后,我们比较了这些成像工具在临床环境中的效用。总之,我们认为 LUS 是最有用和最有前途的成像技术,因为它具有高灵敏度、可重复性和可及性。然而,CXR 和胸部 CT 的价值在于它们能够进行鉴别诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c248/10037625/7412afaa3dc0/arm-91-00010-g001.jpg

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