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目的评价经胸肺超声对间质性肺疾病(ILD)的应用价值。方法 ILD患者85例和非ILD患者44例,均行经胸肺超声及HRCT检查,分析胸膜和肺实质的图像,记录下列声像图:(1)B线条数;(2)胸膜线是否规则及其厚度;(3)胸膜下有无结节。以临床诊断为金标准,分别计算经胸肺超声及CT诊断ILD的灵敏度、特异度、阳性预测值、阴性预测值以及准确度,计算两者诊断ILD的Kappa值。P<0.05为差异具有统计学意义。结果以下列声像图特征为诊断依据:(1)双侧胸腔弥漫性分布的B线,一个切面4条以上;(2)胸膜线增厚,不规则;(3)胸膜下散在小结节样低回声区。CT与超声诊断ILD诊断准确度差异无统计学意义(P=0.167),一致率为86.33%,Kappa值=0.723。结论 ILD的经胸肺超声图像有一定的特征性,肺超声诊断与CT诊断有较好的一致性,超声可作为ILD的一种初步的筛查方法。
Objective To evaluate the value of thoracic ultrasonography in the treatment of interstitial lung disease (ILD). Methods 85 patients with ILD and 44 patients with non-ILD were examined by thoracic ultrasonography and HRCT. The images of pleura and lung were analyzed and the following sonographic images were recorded: (1) the number of B lines; (2) the rules of pleural line and Its thickness; (3) subpleural nodules. With clinical diagnosis as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the diagnosis of ILD by trans-thoracic ultrasonography and computed tomography were respectively calculated, and the Kappa values of ILD were calculated. P <0.05 for the difference was statistically significant. The results of the following diagnostic features based on acoustic features: (1) bilateral pleural diffuse distribution of the B line, a section of more than 4; (2) pleural line thickening, irregular; (3) subpleural scattered in the small nodules Low echo area. The diagnostic accuracy of CT and ultrasonic diagnosis of ILD was not statistically different (P = 0.167), the concordance rate was 86.33% and Kappa value was 0.723. Conclusions The thoracic ultrasonography of ILD has certain characteristics. The diagnosis of pulmonary ultrasonography is in good agreement with the CT diagnosis. Ultrasound can be used as a primary screening method for ILD.