肺部超声与高分辨率CT评估间质性肺疾病的对比研究

A comparative study of lung ultrasound and high resolution CT in the evaluation of interstitial lung disease

目的对比肺部超声(LUS)与高分辨率CT(HRCT)对间质性肺疾病(ILD)的诊断价值。方法收集我院呼吸内科、免疫内科住院的临床疑似ILD患者50例,所有患者均采用LUS及HRCT两种方法对肺部进行检查,评估两种检查方法的诊断效能;采用Buda超声评分法对ILD进行评分,分析其与HRCT Warrick评分的一致性和相关性。结果 LUS与HRCT诊断ILD的敏感性、特异性、阳性预测值、阴性预测值分别为92.3%、81.8%、94.7%、75.0%和97.4%、90.9%、97.4%、90.9%;二者诊断效能比较差异均无统计学意义。LUS与HRCT对不同程度ILD的诊断具有较好的一致性[Kappa=0.879(95%可信区间为0.801~0.958)]。Buda超声评分与HRCT Warrick评分呈强正相关(r=0.859,P<0.001)。结论 LUS可以有效评估ILD,且与HRCT诊断效能相当。

ObjectiveTo investigate and compare the diagnotic value of lung ultrasound(LUS)and high resolution CT(HRCT)in interstitial lung disease(ILD).MethodsA total of 50 patients who were clinically suspected ILD in the respiratory department and immunology department of our hospital were collected.All patients were examined by LUS and HRCT.The diagnostic efficiency of the two methods were evaluated.Buda ultrasound score method was used to score the condition of ILD. The correlation and consistency between the Buda ultrasound score method and HRCT Warrick score method were evaluated.ResultsThe sensitivity,specificity,positive predictive value and negative predictive values of LUS in diagnosing ILD were 92.3%,81.8%,94.7%,75.0%,respectively,and the values of HRCT were 97.4%,90.9%,97.4%,90.9%,respectively.There was no significant difference in diagnostic efficiency between the two methods.There was good consistency between LUS and HRCT in the diagnosis of different severity of ILD(Kappa=0.879,95%CI 0.801~0.958). There was a strong positive correlation between the values calculated according to the Buda ultrasound score method and the HRCT Warrick score method(r=0.859,P<0.001).ConclusionLUS can effectively evaluate ILD,and its diagnosis efficiency is equivalent to HRCT.