肺部超声与CT对新型冠状病毒肺炎肺损伤的评估:优与劣

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

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。

Computerized tomography(CT)is the gold standard of imaging technique for lung injury.During the early outbreak of COVID-19 in Wuhan,China,lung CT played an important role in screening and classification.With the development of COVID-19,patients'lung CT presents different lesion types and ranges.Correspondingly,Lung ultrasonography can help to quickly screen for the potential causes of respiratory failure in COVID-19 patients,which takes advantages of convenience,high-accuracy,non-radiation,and fewer transmission in hospital.Moreover,lung ultrasonography is useful for continuous and dynamic management of COVID-19.It dynamically monitors the disease progression;evaluates the effectiveness of the prone position ventilation;and guides ventilation settings,weaning,and extracorporeal membrane therapy.However,lung ultrasonography has limitations on identifying over-inflation,operator dependence,and so on.Clinicians should take advantages of lung CT and ultrasonography and make each modality complementary to the other for promoting precise strategic treatment of COVID-19 patients.