新生儿肺部超声对先天性肺气道畸形的诊断价值  

The application of neonate lung ultrasound in congenital pulmonary airway malformation

作　　者：冯鑫[1] 俞钢[2] 夏波[2] 尚宁[1] 王丽敏[1] 洪淳[2] 唐晶[2] Feng Xin;Yu Gang;Xia Bo;Shang Ning;Wang Limin;Hong Chun;Tang Jing(Department of Ultrasound,Guangdong Women and Children Hospital,Guangzhou 511440,China;Department of Mother and Fetal Medicine,Guangdong Women and Children Hospital,Guangzhou 511440,China)

机构地区：[1]广东省妇幼保健院超声科,广州511440 [2]广东省妇幼保健院胎儿医学科,广州511440

出　　处：《中华超声影像学杂志》2019年第11期945-950,共6页Chinese Journal of Ultrasonography

摘　　要：目的分析先天性肺气道畸形(CPAM)的肺部超声(LUS)特点,并通过与胸部X线(CXR)进行比较,评价新生儿期LUS对CPAM的诊断价值。方法回顾性分析我院2017年6月至2018年10月32例产前超声以及出生后CT诊断为CPAM的新生儿的LUS和CXR图像特征,并比较LUS和CXR的直接征象、间接征象。结果32例CPAM患儿中,10例(31.25%)表现为单个无回声囊性病灶,其中3例合并肺实变;4例(12.5%)表现为多个大小不等且相通的无回声囊性病灶,其中3例合并肺实变;16例(50%)表现为不规则的低回声肺实变,其内可伴或不伴支气管充气征;2例(6.25%)患儿仅表现为密集B-线。病灶周围非特征性超声表现为胸膜线不光滑、不清晰,A-线减少或消失,密集B-线或B-线融合。新生儿LUS对于病灶大小的测量受限。32例患儿中,CT显示大囊型10例(31.25%),微囊型22例(68.75%)。11例(34.4%)患儿CXR未见异常,CXR与LUS相比,LUS检查的直接征象(包括单个或多个囊性病灶)与CXR的直接征象差异无统计学意义(P=0.8);而LUS的间接征象较CXR的间接征象明显,差异有统计学意义(P=0.001)。结论CPAM患儿的LUS图像表现多样,LUS可用于新生儿期CPAM的初步定性筛查,其间接征象诊断价值优于CXR。Objective To analyze the characteristics of lung ultrasound(LUS)in congenital pulmonary airway malformation(CPAM),and to compare the difference of image characteristics between LUS and chest X-ray(CXR)and evaluate the value of neonate LUS in CPAM.Methods From June 2017 to October 2018,the characteristics of LUS and CXR of 32 neonates who were diagnosed with CPAM by prenatal ultrasound and postnatal chest CT were analyzed retrospectively,and the difference of their direct signs and indirect signs were compared.Results Among 32 CPAM cases,10 cases(31.25%)showed a single large cystic lesions and 3 cases with consolidation,4 cases(12.5%)characterized by multiple hypoechoic lesions and 3 cases with consolidation,16 cases(50%)showed consolidation with or without intensiveaerated bronchus sign or dendritic air-filled bronchi,2 cases(6.25%)only characterized by dense B-line.The non-characteristic sonographic findings including pleural line was not smooth and not clear;A-line decreased or disappeared,dense B-lines were observed.The ability of LUS in measuring the size of CPAM was limited.Among 32 CPAM cases,10 cases(31.25%)showed large cystic hypoechoic lesions and 22 cases(68.75%)showed small cystic hypoechoic lesions by CT scan.In this group,there were 11 cases(34.4%)with normal CXR.There was no significant differences of the direct signs(including single large cystic lesions and multiple hypoechoic lesions)between LUS and CXR(P=0.80),however the indirect signs of LUS were more obvious than CXR,with significant difference(P=0.001).Conclusions The neonatal LUS findings of CPAM is multiple,it can be used as a preliminary qualitative screening method.The diagnosis value of indirect sign of LUS is superior to CXR.

关 键 词：超声检查 肺部 先天性肺气道畸形 胸部CT 胸部X线检查 

分 类 号：R72[医药卫生—儿科]