留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

肺部超声与CT对新型冠状病毒肺炎肺损伤的评估:优与劣

李莉 张丽娜 中国重症超声研究组

李莉, 张丽娜, 中国重症超声研究组. 肺部超声与CT对新型冠状病毒肺炎肺损伤的评估:优与劣[J]. 协和医学杂志, 2020, 11(5): 514-517. doi: 10.3969/j.issn.1674-9081.2020.05.003
引用本文: 李莉, 张丽娜, 中国重症超声研究组. 肺部超声与CT对新型冠状病毒肺炎肺损伤的评估:优与劣[J]. 协和医学杂志, 2020, 11(5): 514-517. doi: 10.3969/j.issn.1674-9081.2020.05.003
Li LI, Li-na ZHANG, Chinese Critical Ultrasound Study Group. Lung Ultrasound and CT Assessment of Lung Injury in COVID-19: Which One is Better[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(5): 514-517. doi: 10.3969/j.issn.1674-9081.2020.05.003
Citation: Li LI, Li-na ZHANG, Chinese Critical Ultrasound Study Group. Lung Ultrasound and CT Assessment of Lung Injury in COVID-19: Which One is Better[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(5): 514-517. doi: 10.3969/j.issn.1674-9081.2020.05.003

肺部超声与CT对新型冠状病毒肺炎肺损伤的评估:优与劣

doi: 10.3969/j.issn.1674-9081.2020.05.003
基金项目: 

北京重症超声协会重症超声专项基金 202001

详细信息
    通讯作者:

    张丽娜  电话:0731-84327095,E-mail: zln7095@163.com

  • 中图分类号: R563.1+3; R445.1

Lung Ultrasound and CT Assessment of Lung Injury in COVID-19: Which One is Better

More Information
    Corresponding author: ZHANG Li-na  Tel:86-731-84327095, E-mail: zln7095@163.com
  • 摘要: 肺部CT是新型冠状病毒肺炎(以下简称“新冠肺炎”)暴发初期最主要的筛查手段和分级诊疗依据,是肺部损伤影像学诊断的金标准。随新冠肺炎病情进展,患者肺部CT呈现不同的病变范围与类型。肺部超声与CT相一致,随病程发展呈特征性表现。与肺部CT相比,肺部超声检查具有床旁便捷、无创等优点,减少了院内传染和转运风险,且其有助于快速鉴别呼吸衰竭的病因,实现连续动态监测,指导呼吸机参数设置、肺复张、俯卧位治疗等,在急危重症新冠肺炎的救治过程中发挥无可替代的作用。另一方面,肺部超声在探测远离胸膜病变、辨别过度通气、操作者依赖方面亦有其局限性。本文对肺部超声与CT的优劣势进行梳理,临床医师在实践过程中应取长补短,以促进新冠肺炎患者的精准诊治。
    利益冲突:无
  • 图  1  一例新冠肺炎患者的典型肺部超声声像(A、B、C、D)和CT(E)影像图

    A.右肺前侧超声表现正常,对应的CT(E①)显示正常通气;B.右肺背侧超声显示少量液暗区及小片实变,对应的CT(E②)显示胸腔积液及肺实性病灶;C.左肺前外侧超声显示为多发局灶(△)和弥漫融合(□)的B模式,对应的CT(E③)为片状渗出;D.左肺背侧超声显示为微量液暗区、胸膜线不规则(○)及多发B模式, 对应CT(E④)为微量胸腔积液及少量渗出病灶

  • [1] 国家卫生健康委员会办公厅.新型冠状病毒感染的肺炎诊疗方案(试行第五版)[EB/OL].(2020-02-05). http://www.gov.cn/zhengce/zhengceku/2020-02/05/5474791/files/de44557832ad4be1929091dcbcfca891.pdf.
    [2] Convissar D, Gibson LE, Berra L, et al. Application of Lung Ultrasound duringthe COVID-19 Pandemic: A Narrative Review[J]. Anesth Analg, 2020, 131:345-350. doi:  10.1213/ANE.0000000000004929
    [3] 中国研究型医院学会感染与炎症放射学专业委员会, 中国医师协会放射医师分会感染影像专业委员会, 中华医学会放射学分会传染学组中国性病艾滋病防治协会感染(传染病)影像工作委员会, 等.新型冠状病毒肺炎影像诊断指南(2020年第二版简版)[J].首都医科大学学报, 2020, 42:168-173. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=sdykdxxb202002004
    [4] Peng QY, Wang XT, Zhang LN, et al. Findings of lung ultrasonography of novel corona virus pneumonia during the 2019-2020 epidemic[J]. Intensive Care Med, 2020, 46:849-850. doi:  10.1007/s00134-020-05996-6
    [5] Fiala MJ. Ultrasound in COVID-19: a timeline of ultrasound findings in relation to CT[J]. Clin Radiol, 2020, 75:553-554. doi:  10.1016/j.crad.2020.04.003
    [6] Chen TY. Lung ultrasound in the monitoring of COVID-19 infection[J]. Clin Med (Lond), 2020, 20:e62-e65. doi:  10.7861/clinmed.2020-0123
    [7] Chiumello D, Umbrello M, Sferrazza Papa GF, et al. Global and Regional Diagnostic Accuracy of Lung Ultrasound Compared to CT in Patients With Acute Respiratory Distress Syndrome[J]. Crit Care Med, 2019, 47:1599-1606. doi:  10.1097/CCM.0000000000003971
    [8] Smith MJ, Hayward SA, Innes SM, et al. Point-of-care lung ultrasound in patients with COVID-1-a narrative review[J]. Anaesthesia, 2020, 75:1096-1104. doi:  10.1111/anae.15082
    [9] 张丽娜, 尹万红, 何伟, 等.基于重症超声的重症新型冠状病毒肺炎救治建议[J/OL].中华内科杂志, 2020, 59(2020-06-15).http://rs.yiigle.com/yufabiao/1202852.htm.
    [10] Mayo PH, Copetti R, Feller-Kopman D, et al. Thoracic ultrasonography: a narrative review[J]. Intensive Care Med, 2019, 45:1200-1211. doi:  10.1007/s00134-019-05725-8
    [11] Liu LL, Aldrich JM, Shimabukuro DW, et al. Special article: rescue therapies for acute hypoxemic respiratory failure[J]. Anesth Analg, 2010, 111:693-702. doi:  10.1213/ANE.0b013e3181e9c356
    [12] Yassa M, Birol P, Mutlu AM, et al. Lung Ultrasound Can Influence the Clinical Treatment of Pregnant Women With COVID-19[J]. J Ultrasound Med, 2020.doi: 10.1002/jum.15367.
    [13] Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence-based recommendations for point-of-care lung ultrasound[J]. Intensive Care Med, 2012, 38:577-591. doi:  10.1007/s00134-012-2513-4
    [14] Mongodi S, Via G, Girard M, et al. Lung Ultrasound for Early Diagnosis of Ventilator-Associated Pneumonia[J]. Chest, 2016, 149:969-980. doi:  10.1016/j.chest.2015.12.012
    [15] Peng QY, Wang XT, Zhang LN, et al. Using echocardiography to guide the treatment of novel coronavirus pneumonia[J]. Crit Care, 2020, 24:143. doi:  10.1186/s13054-020-02856-z
    [16] 邢志群, 王小亭, 刘大为.重症超声:血流动力学的推手[J].协和医学杂志, 2019, 10:461-464. http://oldmed.wanfangdata.com.cn/Paper/Detail/PeriodicalPaper_xhyx201905008
    [17] Mojoli F, Bouhemad B, Mongodi S, et al. Lung Ultrasound for Critically Ill Patients[J]. Am J Respir Crit Care Med, 2019, 199:701-714. doi:  10.1164/rccm.201802-0236CI
    [18] Jr LeCour L, Boyapati VK, Liu J, et al. The Structural Basis for Cdc42-Induced Dimerization of IQGAPs[J]. Structure, 2016, 24:1499-1508. doi:  10.1016/j.str.2016.06.016
    [19] Kulkarni S, Down B, Jha S. Point-of-care (POC) lung ultrasound in intensive care during the COVID-19 pandemic [J]. Clin Radiol, 2020.doi: 10.1016/j.crad.2020.05.001.
    [20] Antunez-Montes OY, Buonsenso D. Routine use of Point-of-Care lung ultrasound during the COVID-19 pandemic[J]. Med Intensiva, 2020. doi:  10.1016/j.medin.2020.04.010.
  • 加载中
图(1)
计量
  • 文章访问数:  124
  • HTML全文浏览量:  43
  • PDF下载量:  13
  • 被引次数: 0
出版历程
  • 收稿日期:  2020-07-06
  • 刊出日期:  2020-09-30

目录

    /

    返回文章
    返回

    【温馨提醒】近日,《协和医学杂志》编辑部接到作者反映,有多名不法人员冒充期刊编辑发送见刊通知,鼓动作者添加微信,从而骗取版面费的行为。特提醒您,本刊与作者联系的方式均为邮件通知或电话,稿件进度通知邮箱为:mjpumch@126.com,编辑部电话为:010-69154261,请提高警惕,谨防上当受骗!如有任何疑问,请致电编辑部核实。谢谢!