肺超声B线联合不规则胸膜线在结缔组织病相关间质性肺疾病的应用研究  

Application study of lung ultrasound B-lines combined with pleural irregularity in connective tissue disease associated interstitial lung disease

作　　者：王育凯 林樟樟 杜光舟[3] 陈绍琦[2] 林建群[1] 林啟胜 谢雪珍 胡仕建 WANG Yukai;LIN Zhangzhang;DU Guangzhou;CHEN Shaoqi;LIN Jianqun;LIN Qisheng;XIEXuezhen;HU Shijian(Department of Rheumatology and Immunology,Shantou Central Hospital,Shantou 515031,China;Department ofUltrasound,The First Affiliated Hospital of Shantou University Medical College,Shantou 515041,China;Department ofRadiology,Shantou Central Hospital, Shantou 515031,China)

机构地区：[1]汕头市中心医院风湿免疫科,广东汕头515031 [2]汕头大学医学院第一附属医院超声科,广东汕头515041 [3]汕头市中心医院影像科,广东汕头515031

出　　处：《汕头大学医学院学报》2019年第2期86-91,共6页Journal of Shantou University Medical College

基　　金：广东省自然科学基金(2014A030307003)

摘　　要：目的:评价肺超声B线和不规则胸膜线(pleural irregularity,PI)诊断结缔组织病相关间质性肺疾病(connective tissue disease associated interstitial lung disease,CTD-ILD)的临床价值。方法:选取33例经胸部高分辨CT(high resolution CT,HRCT)确诊的CTD-ILD患者进行肺超声检查。HRCT检查采用Warrick评分评估肺间质性病变严重程度和范围。选取50个肋间隙进行肺超声检测及B线评分。检测胸膜线时,将肺表面(前、侧面)划分为8个区域,统计每个区域内PI主要影像学表现,与相应区域内HRCT主要的影像学表现进行对应分析。分析B线评分与Warrick评分及PI和HRCT影像学表现的相关性。结果:33例CTD-ILD患者的肺超声B线评分和HRCT的Warrick评分有较好的相关性(r=0.61,95%CI:0.34~0.78,P<0.05)。肺超声PI和HRCT影像学表现也有较好的相关性(r=0.60,95%CI:0.51~0.67,P<0.05)。结论:CTD-ILD患者的肺超声B线评分和PI影像学表现与HRCT的Warrick评分及影像学表现具有较好的一致性。肺超声可作为一种非侵入性、无放射性的筛查和随访CTD-ILD患者的影像学方法。Objective:To assess the clinical value of B-lines and pleural irregularity (PI) of lung ultrasound in the diagnosis of connective tissue disease associated interstitial lung disease (CTD- ILD). Methods: Lung ultrasound was performed in 33 patients with CTD-ILD confirmed by chest high resolution CT. The severity and extent of pulmonary interstitial lesions were assessed by Warrick score on HRCT. Fifty intercostal spaces were selected for lung ultrasound detection and B-line score. When pleural line was detected,the lung surface was divided into eight regions. The main imaging manifestations of PI in each region were counted and analyzed with the main imaging manifestations of HRCT in the corresponding regions. The correlation between B- lines score and Warrick score, PI pattern and HRCT pattern were analyzed. Results: There was a good correlation between B-line score of lung ultrasound and Warrick score of HRCT in 33 patients with CTD-ILD (r=0.61,95% CI:0.34~0.78,P<0.05). PI patterns of lung ultrasound and imaging patterns of HRCT also had a good correlation (r=0.60, 95% CI: 0.51~0.67,P<0.05). Conclusions: Lung ultrasound in patients with CTD-ILD is in good agreement with HRCT. Lung ultrasound can be used as a non-invasive,non-radioactive imaging method for screening and follow-up of CTD-ILD patients.

关 键 词：肺超声 B线 不规则胸膜线 高分辨CT 结缔组织病相关间质性肺疾病 

分 类 号：R445.1[医药卫生—影像医学与核医学] R563.13[医药卫生—诊断学]