Dres Martin, Doorduin Jonne, Boussouar Samia, Bachasson Damien
Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005, Paris, France.
Département R3S (Respiration, Réanimation, Réadaptation Respiratoire, Sommeil), Service de Médecine Intensive-Réanimation (Département "R3S"), AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, 47-83 boulevard de l'Hôpital, 75013, Paris, France.
Crit Care. 2025 Mar 12;29(1):110. doi: 10.1186/s13054-025-05339-1.
This review highlights the latest advancements in imaging techniques for monitoring respiratory muscles in critically ill patients. At the bedside, conventional ultrasound has been widely adopted to measure diaphragm thickness, thickening and excursion. It has also been used to assess extradiaphragmatic respiratory muscles, including parasternal intercostal and abdominal muscles. Advanced ultrasound-derived techniques have expanded its applications, enabling the evaluation of tissue velocity (tissue Doppler imaging), stiffness (shear wave elastography), and local tissue displacement (speckle tracking). Facility-based imaging modalities such as magnetic resonance imaging and chest tomography provide complementary insights into respiratory muscles structure and function, offering valuable information for evaluating the effects of therapeutic interventions. Finally, imaging techniques have emerged as valuable tools for evaluating the metabolic demands of respiratory muscles, with advanced methods such as positron emission tomography and contrast-enhanced ultrasound showing significant potential.
本综述重点介绍了用于监测危重症患者呼吸肌的成像技术的最新进展。在床边，传统超声已被广泛用于测量膈肌厚度、增厚和移动度。它还被用于评估膈肌外呼吸肌，包括胸骨旁肋间肌和腹肌。先进的超声衍生技术扩展了其应用范围，能够评估组织速度（组织多普勒成像）、硬度（剪切波弹性成像）和局部组织位移（斑点追踪）。基于设备的成像方式，如磁共振成像和胸部断层扫描，为呼吸肌的结构和功能提供了补充性见解，为评估治疗干预的效果提供了有价值的信息。最后，成像技术已成为评估呼吸肌代谢需求的有价值工具，正电子发射断层扫描和对比增强超声等先进方法显示出巨大潜力。
