Paredes-Manjarrez Carlos, Avelar-Garnica Francisco J, Balderas-Chairéz Andres Tlacaelel, Arellano-Sotelo Jorge, Córdova-Ramírez Ricardo, Espinosa-Poblano Eliseo, González-Ruíz Alejandro, Anda-Garay Juan Carlos, Miguel-Puga José Adan, Jáuregui-Renaud Kathrine
Departamento de Imagenología, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico.
Departamento de Inhaloterapia y Neumología, Hospital de Especialidades del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico.
J Clin Med. 2023 Dec 5;12(24):7515. doi: 10.3390/jcm12247515.
The aim of this study was to assess the shear wave velocity by LUS elastography (SWE2D) for the evaluation of superficial lung stiffness after COVID-19 pneumonia, according to "fibrosis-like" signs found by Computed Tomography (CT), considering the respiratory function. Seventy-nine adults participated in the study 42 to 353 days from symptom onset. Paired evaluations (SWE2D and CT) were performed along with the assessment of arterial blood gases and spirometry, three times with 100 days in between. During the follow-up and within each evaluation, the SWE2D velocity changed over time (MANOVA, < 0.05) according to the extent of "fibrosis-like" CT signs by lung lobe (ANOVA, < 0.05). The variability of the SWE2D velocity was consistently related to the first-second forced expiratory volume and the forced vital capacity (MANCOVA, < 0.05), which changed over time with no change in blood gases. Covariance was also observed with age and patients' body mass index, the time from symptom onset until hospital admission, and the history of diabetes in those who required intensive care during the acute phase (MANCOVA, < 0.05). After COVID-19 pneumonia, SWE2D velocity can be related to the extent and regression of "fibrotic-like" involvement of the lung lobes, and it could be a complementary tool in the follow-up after COVID-19 pneumonia.
本研究的目的是根据计算机断层扫描（CT）发现的“纤维化样”征象，并结合呼吸功能，通过肺部超声弹性成像（SWE2D）评估新冠病毒肺炎后浅表肺硬度的剪切波速度。79名成年人参与了本研究，他们在症状出现后42至353天接受评估。在评估动脉血气和肺活量测定的同时进行了配对评估（SWE2D和CT），共进行三次，每次间隔100天。在随访期间以及每次评估中，SWE2D速度随时间变化（多变量方差分析，P<0.05），这取决于肺叶“纤维化样”CT征象的程度（方差分析，P<0.05）。SWE2D速度的变异性始终与第一秒用力呼气量和用力肺活量相关（协方差分析，P<0.05），它们随时间变化，而血气无变化。还观察到与年龄、患者体重指数、症状出现至入院的时间以及急性期需要重症监护的患者的糖尿病史存在协方差（协方差分析，P<0.05）。新冠病毒肺炎后，SWE2D速度可能与肺叶“纤维化样”受累的程度和消退有关，它可能是新冠病毒肺炎后随访中的一种补充工具。
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