结缔组织病相关性间质性肺疾病超声与HRCT相关性的初步研究
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摘要
目的探讨结缔组织病相关性间质性肺疾病超声与HRCT的相关性。方法选取我院风湿免疫科明确诊断为结缔组织病的患者70例,分别行肺超声及HRCT获得B线、Warrick评分并进行相关性分析,对两种评分进行分级,并对分级结果进行一致性分析。结果 LUS的灵敏度、特异度、阳性似然比和阴性似然比分别为82%、80%、4.1、0.225。Spearman相关分析表明,肺超声评分及HRCT评分在P=0.05水平呈强烈正相关(r=0.870,P<0.001),两种分级结果一致性Kappa值为0.598。结论结缔组织病相关性间质性肺疾病超声与HRCT具有良好的相关性,肺超声可以作为一种诊断及评估结缔组织病相关性间质性肺疾病的新型影像学方法。
Objective To investigate the correlation between lung ultrasound(LUS)and HRCT of connective tissue disease associated interstitial lung disease(CTD-ILD).Methods 70 patients with CTD were selected in the department of rheumatology of our hospital.All subjects underwent HRCT followed by lung ultrasound,we obtained and graded B line score and Warrick score.The correlation between two scores and the consistency of two grades were analysed.Results The sensitivity,specificity,positive and negative predictive value of LUS was 82%,80%,4.1,0.225.A significantly positive correlation between LUS score and HRCT score(r=0.870,P<0.001)was found.Kappa values for two grades was 0.598.Conclusions There is a significantly positive correlation between LUS and HRCT in CTD-ILD.LUS could be a new imaging method for diagnosis and evaluation of CTD-ILD.
Objective To investigate the correlation between lung ultrasound(LUS)and HRCT of connective tissue disease associated interstitial lung disease(CTD-ILD).Methods 70 patients with CTD were selected in the department of rheumatology of our hospital.All subjects underwent HRCT followed by lung ultrasound,we obtained and graded B line score and Warrick score.The correlation between two scores and the consistency of two grades were analysed.Results The sensitivity,specificity,positive and negative predictive value of LUS was 82%,80%,4.1,0.225.A significantly positive correlation between LUS score and HRCT score(r=0.870,P<0.001)was found.Kappa values for two grades was 0.598.Conclusions There is a significantly positive correlation between LUS and HRCT in CTD-ILD.LUS could be a new imaging method for diagnosis and evaluation of CTD-ILD.
引文
[1]王凯,殷松楼.结缔组织病相关间质性肺病的诊治进展[J].中国免疫学杂志,2016,32(10):1562-1565.
[2] JEE A S,CORTE T J,WORT S J,et al.Year in review 2016:Interstitial lung disease,pulmonary vascular disease,pulmonary function,paediatric lung disease,cystic fibrosis and sleep[J].Respirology,2017.
[3] BROWNELL R,MOUA T,HENRY T S,et al.The use of pretest probability increases the value of high-resolution CT in diagnosing usual interstitial pneumonia[J].Thorax,2017,72(5):424-429.
[4]黄向红,黄小莉.经胸肺超声与CT对间质性肺疾病的诊断一致性初步探讨[J].中国超声医学杂志,2016,32(5):410-413.
[5]潘金兵,李晓,陈银,等.弥漫性肺疾病经支气管镜超声检查的初步研究[J].中国超声医学杂志,2018,34(3):282-285.
[6] LICHTENSTEIN D.Lung ultrasound in the critically ill[J].Annals of Intensive Care,2014,17(1):315-322.
[7] SOLDATI G,GIUNTA V,SHER S,et al."Synthetic"comets:a new look at lung sonography[J].Ultrasound in Medicine&Biology,2011,37(11):1762-1770.
[8] MOHAMMADI A,OSHNOEI S,GHASEMIRAD M.Comparison of a new,modified lung ultrasonography technique with high-resolution CT in the diagnosis of the alveolo-interstitial syndrome of systemic scleroderma[J].Geburtshilfe Und Frauenheilkunde,2012,72(8):705-707.
[9] BUDA N,PISKUNOWICZ M,PORZEZISKA M,et al.Lung Ultrasonography in the Evaluation of Interstitial Lung Disease in Systemic Connective Tissue Diseases:Criteria and Severity of Pulmonary Fibrosis-Analysis of 52Patients[J].Ultraschall in Der Medizin,2015,37(4):379-385.
[10] WARRICK J H,BHALLA M,SCHABEL S I,et al.High resolution computed tomography in early scleroderma lung disease[J].Journal of Rheumatology,1991,18(10):1520.
[11] DURHEIM M T,KIM S,GULACK B C,et al.Mortality and Respiratory Failure After Thoracoscopic Lung Biopsy for Interstitial Lung Disease[J].Annals of Thoracic Surgery,2017,104(2):465.
[12] WILLIAMSON J P,GRAINGE C,PARAMESWARAN A,et al.Thoracic Ultrasound:What Non-radiologists Need to Know[J].CurrPulmonol Rep,2017,6(1):39-47.
[13] DIETRICH C F,MATHIS G,BLAIVAS M,et al.Lung B-line artefacts and their use[J].J Thorac Dis,2016,8(6):1356-1365.
[14] COGLIATI C,ANTIVALLE M,TORZILLO D,et al.Standard and pocket-size lung ultrasound devices can detect interstitial lung disease in rheumatoid arthritis patients[J].Rheumatology,2014,53(8):1497-1503.
[15] SONG G,BAE S C,LEE Y H.Diagnostic accuracy of lung ultrasound for interstitial lung disease in patients with connective tissue diseases:a meta-analysis[J].Clin Exp Rheumatol,2016,34(1):11-16.
[2] JEE A S,CORTE T J,WORT S J,et al.Year in review 2016:Interstitial lung disease,pulmonary vascular disease,pulmonary function,paediatric lung disease,cystic fibrosis and sleep[J].Respirology,2017.
[3] BROWNELL R,MOUA T,HENRY T S,et al.The use of pretest probability increases the value of high-resolution CT in diagnosing usual interstitial pneumonia[J].Thorax,2017,72(5):424-429.
[4]黄向红,黄小莉.经胸肺超声与CT对间质性肺疾病的诊断一致性初步探讨[J].中国超声医学杂志,2016,32(5):410-413.
[5]潘金兵,李晓,陈银,等.弥漫性肺疾病经支气管镜超声检查的初步研究[J].中国超声医学杂志,2018,34(3):282-285.
[6] LICHTENSTEIN D.Lung ultrasound in the critically ill[J].Annals of Intensive Care,2014,17(1):315-322.
[7] SOLDATI G,GIUNTA V,SHER S,et al."Synthetic"comets:a new look at lung sonography[J].Ultrasound in Medicine&Biology,2011,37(11):1762-1770.
[8] MOHAMMADI A,OSHNOEI S,GHASEMIRAD M.Comparison of a new,modified lung ultrasonography technique with high-resolution CT in the diagnosis of the alveolo-interstitial syndrome of systemic scleroderma[J].Geburtshilfe Und Frauenheilkunde,2012,72(8):705-707.
[9] BUDA N,PISKUNOWICZ M,PORZEZISKA M,et al.Lung Ultrasonography in the Evaluation of Interstitial Lung Disease in Systemic Connective Tissue Diseases:Criteria and Severity of Pulmonary Fibrosis-Analysis of 52Patients[J].Ultraschall in Der Medizin,2015,37(4):379-385.
[10] WARRICK J H,BHALLA M,SCHABEL S I,et al.High resolution computed tomography in early scleroderma lung disease[J].Journal of Rheumatology,1991,18(10):1520.
[11] DURHEIM M T,KIM S,GULACK B C,et al.Mortality and Respiratory Failure After Thoracoscopic Lung Biopsy for Interstitial Lung Disease[J].Annals of Thoracic Surgery,2017,104(2):465.
[12] WILLIAMSON J P,GRAINGE C,PARAMESWARAN A,et al.Thoracic Ultrasound:What Non-radiologists Need to Know[J].CurrPulmonol Rep,2017,6(1):39-47.
[13] DIETRICH C F,MATHIS G,BLAIVAS M,et al.Lung B-line artefacts and their use[J].J Thorac Dis,2016,8(6):1356-1365.
[14] COGLIATI C,ANTIVALLE M,TORZILLO D,et al.Standard and pocket-size lung ultrasound devices can detect interstitial lung disease in rheumatoid arthritis patients[J].Rheumatology,2014,53(8):1497-1503.
[15] SONG G,BAE S C,LEE Y H.Diagnostic accuracy of lung ultrasound for interstitial lung disease in patients with connective tissue diseases:a meta-analysis[J].Clin Exp Rheumatol,2016,34(1):11-16.