三种经胸肺部超声检查技术诊断间质性肺疾病的可重复性及一致性  

Repeatability and consistency of three transthoracic lung ultrasound technologies in diagnosis of interstitial lung disease

作　　者：连细华 张颖 朱志兴[2] 吕国荣[1,3] LIAN Xihua;ZHANG Ying;ZHU Zhixing;LYU Guorong(Department of Ultrasound,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China;Department of Pulmonary and Critical Care Medicine,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China;Fujian Quanzhou Medical College,Collaborative Innovation Center for Maternal and Infant Health Service Application Technology,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院超声医学科,福建泉州362000 [2]福建医科大学附属第二医院呼吸与危重症医学科,福建泉州362000 [3]福建省泉州医学高等专科学校母婴健康服务应用技术协同创新中心,福建泉州362000

出　　处：《中国医学影像技术》2020年第5期702-706,共5页Chinese Journal of Medical Imaging Technology

基　　金：福建省卫生计生青年科研课题(2018-1-62);泉州市科技计划项目(2018N012S);福建省泉州医学高等专科学校母婴健康服务应用技术协同创新中心基金项目(XJM1802)。

摘　　要：目的探讨3种经胸肺部超声检查(TLUS)技术诊断间质性肺疾病(ILD)的可重复性及一致性。方法由2名超声科医师对40例ILD患者分别采用简化的14肋间隙扫查法、28肋间隙扫查法、72肋间隙扫查法行TLUS,对比同一医师及不同医师采用不同技术检测结果的可重复性、一致性及扫查时间。结果同一医师和不同医师利用3种超声技术对B线评价的可重复性及一致性均较高,其中同一医师利用14肋间隙扫查法的可重复性[ICC=0.9891,95%CI(0.9772,0.9948)]及一致性最高[界限宽度0.57±2.79,95%CI(-0.47,1.61)],不同医师利用14肋间隙扫查法的可重复性[ICC=0.9795,95%CI(0.9575,0.9902)]及一致性最高[界限宽度0.70±3.77,95%CI(-0.71,2.11)]。同一医师、不同医师利用14肋间隙扫查法观察胸膜线严重程度的一致性高(Kappa值=0.948、0.895,P均<0.001)。3种超声技术扫查时间差异有统计学意义(P<0.001),其中14肋间隙扫查法时间最短,72肋间隙扫查法最长。结论3种TLUS技术中,14肋间隙扫查法的可重复性及一致性最高,且用时最短。Objective To explore the repeatability and consistency of three transthoracic lung ultrasound(TLUS)technologies in diagnosis of interstitial lung disease(ILD).Methods Totally 40 ILD patients were selected and examined separately using the simplified 14 intercostals space method,28 intercostals space method and 72 intercostals space method by two ultrasound physicians.The repeatability,consistency and examination time of each ultrasonography method were calculated.Results The intra-/inter-physicians repeatability and consistency of 3 ultrasonography methods in evaluating B line were high.The intra-physicians repeatability(ICC=0.9891,95%CI[0.9772,0.9948])and consistency(boundary width of 0.57±2.79,95%CI[-0.47,1.61])of measuring B lines using 14 intercostals space method were the highest,while the inter-physicians repeatability(ICC=0.9795,95%CI[0.9575,0.9902])and consistency(boundary width of 0.70±3.77,95%CI[-0.71,2.11])of measuring B lines using 14 intercostals space method were the highest.The intra-/inter-physicians consistency of pleural line observation using 14 intercostals space method were high(Kappa=0.948,0.895,both P<0.001).The examination time of 3 ultrasonography methods were different,the 14 intercostals space method took the shortest time,while the 72 intercostals space method took the longest time(P<0.001).Conclusion Diagnosing ILD with 14 intercostals space method is of great clinical value for high repeatability and consistency and short examination time.

关 键 词：肺疾病 间质性 超声检查 可重复性 结果 

分 类 号：R563.9[医药卫生—呼吸系统] R445.1[医药卫生—内科学]