小儿术前肺超声剪切波弹性成像的初步研究  

A preliminary study of lung ultrasound shear wave elastography in children during the preoperative period

作　　者：孙莉萍 吴蕾 王红 张瑞冬[1] 张剑蔚[1] 白洁[1] 郑吉建[3] Sun Liping;Wu Lei;Wang Hong;Zhang Ruidong;Zhang Jianwei;Bai Jie;Zheng Jijian(Department of Anesthesiology,Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Ultrasonic Application Department of Shanghai Electric Medical System,Shanghai 201203,China;Department of Anesthesiology,Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine,Pediatric Clinical Pharmacology Laboratory,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心麻醉科,200127 [2]上海电气医疗系统超声应用部,201203 [3]上海交通大学医学院附属上海儿童医学中心麻醉科,儿科临床药理学实验室,200127

出　　处：《国际麻醉学与复苏杂志》2021年第1期30-33,共4页International Journal of Anesthesiology and Resuscitation

基　　金：上海市科学技术委员会医学指导项目(16411967500);上海市卫生委员会青年学者研究基金(20194Y0094)。

摘　　要：目的探讨肺超声剪切波弹性(lung shear wave elasticity,LUSWE)成像技术用于评估小儿术前肺组织弹性的可行性。方法选择2018年10月—2019年6月在上海儿童医学中心全身麻醉下行择期外科手术的患儿32例,年龄4个月~11岁,ASA分级Ⅰ~Ⅲ级,性别不限。按病种将患儿分为先天性心脏病组(先心病组)和非先天性心脏病组(非先心病组)。入选患儿机械通气5 min后,行肺部超声扫描并测量胸膜线下方各区域肺剪切波速度(shear wave velocity,SWV)。结果先心病组患儿右上前区(superoanterior area,SA)和上肺SWV大于非先心病组患儿(P<0.05),其余差异无统计学意义(P<0.05)。组内比较,非先心病组患儿下肺SWV大于上肺,左下肺SWV大于左上肺(P<0.05);先心病组患儿各区域肺SWV差异无统计学意义(P>0.05)。结论LUSWE能够快速、实时和灵敏地测量各区域肺组织弹性。Objective To explore the use of lung ultrasound shear wave elastography(LUSWE)in evaluating the elasticity of lung tissues in children before surgery.Methods A total of 32 children,aged from 4 months to 11 years old,American Society of Anesthesiologists(ASA)Ⅰ-Ⅲ,were selected,who were scheduled for surgery under general anesthesia in Shanghai Children's Medical Center from October 2018 to June 2019.According to their conditions,the patients were divided into two groups:a congenital heart disease(CHD)group and a non-CHD group.After mechanical ventilation for 5 min,they underwent lung ultrasonography and the shear wave velocity(SWV)in each region under the pleura was measured.Results The CHD group presented remarkably higher SWV in the right superoanterior area(SA)and upper lung region than the non-CHD group(P<0.05).Furthermore,the non-CHD group presented remarkable increases in SWV in the lower lung region compared with those in the upper lung region,as well as increases SWV in the left lower lung region compared with those in left upper lung area(P<0.05).Meanwhile,there was no statistical difference as to SWV in each region of the lung for children in the CHD group(P>0.05).Conclusions LUSWE can quickly measure the elasticity of lung tissues in children in a real-time and sensitive manner.

关 键 词：肺 超声 剪切波弹性成像 儿童 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.5[医药卫生—诊断学]