Chen Ming, Zhou Xiaopei
Department of Ultrasound Imaging, Pu Ren Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei, 430081, People's Republic of China.
Department of Intensive Care Medicine, Wuhan Red Cross Hospital, Wuhan, Hubei, 430015, People's Republic of China.
Int J Gen Med. 2025 Sep 12;18:5421-5431. doi: 10.2147/IJGM.S527919. eCollection 2025.
To investigate the diagnostic value of bedside lung ultrasound and chest computed tomography (CT) for subpleural lesions and lung consolidation in intensive care unit (ICU) patients with severe pneumonia.
A retrospective selection was made of 100 ICU patients with severe pneumonia who were treated in our hospital from June 2020 to July 2024 as the research subject group. All patients underwent bedside lung ultrasound and chest CT examinations, and the CT imaging manifestations of the patients were observed. Using the CT examination results as the gold standard, the patients were divided into the lung consolidation group and non-lung consolidation group. The relevant data were collected and the clinical data of the two groups were observed. The positive predictive value, negative predictive value, specificity, sensitivity and accuracy of bedside lung ultrasound in the diagnosis of subpleural lesions and lung consolidation were analyzed.
Chest CT showed that 73.00% of the patients had ≥2 lung lobes involved, mainly in the right lung (61.00%). 56.00% patients had 1-2 organs involved, mainly kidney (77.00%) or heart (87.00%). 69.00% of patients had pulmonary consolidation, 86.00% had bronchial shadow, and 82.00% had mass, patchy or nodular shadow. Compared with the non-lung consolidation group, the lung ultrasound score of the lung consolidation group was significantly increased (<0.05), and the proportion of lung parenchyma, the number of subpleural lesions and the number of pleural intercostal changes were significantly increased (<0.05). The consistency test showed that bedside ultrasound had a high consistency with chest CT in the diagnosis of subpleural lesions and lung consolidation (Kappa=0.678, <0.05; Kappa=0.743, < 0.05).
Bedside lung ultrasound and chest CT had a high consistency in the diagnosis of subpleural lesions and lung consolidation, which may be used as an important method to judge the development of severe pneumonia in ICU.
探讨床旁肺部超声与胸部计算机断层扫描（CT）对重症监护病房（ICU）重症肺炎患者胸膜下病变及肺实变的诊断价值。
回顾性选取2020年6月至2024年7月在我院接受治疗的100例ICU重症肺炎患者作为研究对象组。所有患者均接受床旁肺部超声及胸部CT检查，观察患者的CT影像表现。以CT检查结果为金标准，将患者分为肺实变组和非肺实变组。收集相关数据，观察两组的临床资料。分析床旁肺部超声诊断胸膜下病变及肺实变的阳性预测值、阴性预测值、特异性、敏感性及准确性。
胸部CT显示，73.00%的患者累及≥2个肺叶，主要累及右肺（61.00%）。56.00%的患者累及1 - 2个器官，主要为肾脏（77.00%）或心脏（87.00%）。69.00%的患者有肺实变，86.00%有支气管影，82.00%有肿块、斑片状或结节状影。与非肺实变组相比，肺实变组的肺部超声评分显著升高（<0.05），肺实质比例、胸膜下病变数量及胸膜肋间改变数量显著增加（<0.05）。一致性检验显示，床旁超声在诊断胸膜下病变及肺实变方面与胸部CT具有较高的一致性（Kappa = 0.678，<0.05；Kappa = 0.743，<0.05）。
床旁肺部超声与胸部CT在诊断胸膜下病变及肺实变方面具有较高的一致性，可作为判断ICU重症肺炎病情发展的重要方法。
