肺脏超声异常征象在儿童肺炎诊断中的价值

Diagnostic values of abnormal features of lung ultrasonography in children's pneumonia

目的分析比较肺脏超声异常征象在儿童肺炎诊断中的价值。方法回顾性分析91例接受肺脏超声检查的病例资料,将各超声征象的诊断结果与临床诊断相对照,分别计算其诊断效能,采用二元Logistic回归分析并构建受试者工作特征(ROC)曲线,比较各征象在儿童肺炎诊断中的价值。结果经临床诊断,91例中有56例肺炎、35例无肺炎。B线、A线异常、胸膜线异常、肺滑动征异常、肺实变、胸腔积液是儿童肺炎的主要超声征象;肺实变是儿童肺炎最相关的超声征象(P<0.001),ROC曲线下面积(AUC)为0.845(P<0.001),敏感性为80.4%,特异性为88.6%,准确性为83.5%。结论 B线、A线异常、胸膜线异常、肺滑动征异常、肺实变、胸腔积液对于诊断儿童肺炎具有重要意义,其中肺实变是最有价值的超声征象。

Objective To evaluate the diagnostic values of abnormal features of lung ultrasonography in children?s pneumonia. Methods The examination results of lung ultrasonography in 91 patients were analyzed retrospectively. The results of ultrasonography diagnosis and clinical diagnosis of children?s pneumonia were compared, and the diagnostic efficiency was calculated. The binary Logistic analysis and the receiver operating characteristic(ROC) curve were used to investigate the diagnostic values of these features. Results There were 56 cases with pneumonia and 35 cases without pneumonia. The main characteristics of children?s pneumonia were B line, A line abnormalities, pleural line abnormalities, lung sliding sign abnormalities, lung consolidation and pleural effusion. Lung consolidation was most correlated with pneumonia(P<0.001). The area under the ROC curve(AUC) of lung consolidation was 0.845(P<0.001). The sensitivity, specificity and accuracy of lung consolidation were 80.4%, 88.6%, and 83.5%, respectively. Conclusion Among all the abnormal features, including B line, A line abnormalities, pleural line abnormalities, lung sliding sign abnormalities, lung consolidation and pleural effusion, of lung ultrasonography in children?s pneumonia, lung consolidation is the most valuable feature with highest specificity and accuracy.