Wu R G, Yuan A, Liaw Y S, Chang D B, Yu C J, Wu H D, Kuo S H, Luh K T, Yang P C
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
Am J Respir Crit Care Med. 1994 Aug;150(2):510-4. doi: 10.1164/ajrccm.150.2.8049838.
To assess the value of color Doppler ultrasound in distinguishing minimal pleural effusion from pleural thickening, a prospective analysis was done on the ultrasonographic findings in 51 patients. Real-time, gray-scale, and color Doppler chest ultrasound examinations were carried out by different sonographers who had no clinical information concerning the patients. The sonographer evaluated the images for internal echogenicity of the effusion, pleural lesions that change shape with respiration, and movable septa and echo-densities in pleural space in conventional gray-scale as well as color signal in color Doppler ultrasound. Of the 35 patients with true effusion, 33 had positive color signal (sensitivity 94.3%, 95% confidence intervals [CI] 89 to 98.6%); in 16 patients without effusion, none had color signal (specificity 100%, 95% CI 83 to 100%). Although real-time, gray-scale ultrasound is also sensitive for detecting minimal effusion (sensitivity 100%, 95% CI 92 to 100%), it is less specific (specificity 68.7%, 95% CI 46 to 91.5%). Five of 16 examinations showing fluid-like lesions were found to be deceptive. With relatively high sensitivity and specificity, this method proved to be a useful diagnostic aid to real-time, gray-scale ultrasound for diagnosis of minimal or loculated effusion.
为评估彩色多普勒超声在鉴别微量胸腔积液与胸膜增厚中的价值，对51例患者的超声检查结果进行了前瞻性分析。由不了解患者临床情况的不同超声检查人员进行实时、灰阶及彩色多普勒胸部超声检查。超声检查人员在传统灰阶图像中评估积液的内部回声、随呼吸改变形状的胸膜病变、胸膜腔内可移动的间隔和回声密度，以及彩色多普勒超声中的彩色信号。在35例真正有积液的患者中，33例有阳性彩色信号（敏感性94.3%，95%置信区间[CI]89%至98.6%）；在16例无积液的患者中，无一例有彩色信号（特异性100%，95%CI83%至100%）。虽然实时灰阶超声对检测微量积液也很敏感（敏感性100%，95%CI92%至100%），但其特异性较低（特异性68.7%，95%CI46%至91.5%）。16例显示液性病变的检查中有5例被发现有误导性。该方法具有相对较高的敏感性和特异性，被证明是实时灰阶超声诊断微量或局限性积液的有用辅助诊断方法。
