几种超声征象在气胸诊断中的作用评价  

Different Ultrasound Signs in Pneumothorax

作　　者：时平[1] 鲁树坤[1] 潘敏[1] 张雁[1] 

机构地区：[1]北京大学深圳医院超声影像科,深圳市518036

出　　处：《中国超声医学杂志》2010年第10期899-901,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨不同超声征象在气胸诊断中的价值。方法回顾性分析116例临床怀疑气胸并被CT证实的65侧(62例)气胸及59侧气胸的对侧非气胸胸腔和108侧(54例)非气胸患者胸腔的同期胸部超声影像资料。结果 "肺滑动"征和"彗尾"征同时缺失诊断气胸的准确性最高,为96.6%(P<0.005)。"肺点"对于气胸的特异性100%(P<0.005),敏感性36.9%,对少量气胸敏感性100%。"肺滑动"征缺失或/和"彗尾"征缺失的气胸阴性预测值100%。目标病灶消失为2例穿刺后气胸的共同特征。结论 "肺滑动征"和"彗尾征"同时缺失是诊断气胸的较为可靠指标,"肺点"可作为少量气胸特征为临床保守治疗提供依据,"肺滑动"征或"彗尾"征的存在可排除气胸,而目标病灶的消失应是穿刺引发气胸的佐证。Objective To study the value of different ultrasonic signs in pneumothorax. Methods 116 patients doubted pneumothorax were examined with CT and ultrasound. Pneumothorax was diagnosed by ultrasound when one of the ultrasound signs（lung sliding, comet tail artifact,lung sliding together with comet tail, focus punctured ）disappeared or the ＂lung point＂ appeared. The results were compared from those by CT. Results The accuracy of the lung sliding together with comet tail absence in diagnosing pneumothorax was 96.6%, surpassing the rest signs（P〈 0.005）. The ＂lung point＂ specificity and sensitivity of small quantity pneumothorax were 100%. The negative predictive value of disappearance of lung sliding or comet tail was all 100%. The disappearance of the focus in the two punctured cases was pneumothorax＇s feature. Conclusions The diagnosis of the disappearance of lung sliding together with comet tail has high sensitivity and specificity in detecting pneumothorax. The ＂lung point＂ is the specific sign of small quantity pneumothorax. The existence of lung sliding or comet tail may rule out pneumothorax. The disappearance of the focus can prove puncture is the inducement of pneunlothorax.

关 键 词：超声检查 胸膜疾病 气胸 

分 类 号：R561.4[医药卫生—呼吸系统] R445.1[医药卫生—内科学]