Ultrasound最新文献_第7页

Point-of-care ultrasound for the assessment of subglottic and cervical tracheal stenosis: A Prospective, Multicenter, Exploratory Study 即时超声评估声门下和颈部气管狭窄:一项前瞻性、多中心、探索性研究

Ultrasound Pub Date : 2023-09-09 DOI: 10.1183/13993003.congress-2023.pa1830

Gang Hou, Jieru Lin, Mingming Deng

{"title":"Point-of-care ultrasound for the assessment of subglottic and cervical tracheal stenosis: A Prospective, Multicenter, Exploratory Study","authors":"Gang Hou, Jieru Lin, Mingming Deng","doi":"10.1183/13993003.congress-2023.pa1830","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa1830","url":null,"abstract":"Background: Airway dimension measurements are an important component of treatment efficacy assessment and longitudinal follow-up in patients with subglottic stenosis (SGS) and tracheal stenosis. However, noninvasive, nonradioactive method is lack to assess the degree of stenosis. Methods: In this study, volunteers and patients with a diagnosis of SGS underwent point-of-care ultrasonography (POCUS), CT and flexible bronchoscopy. Radiologist determined the anteroposterior and transverse diameters of the trachea on the CT image and calculated the mean value (CT-mean). Air column width (ACW) and anterior tracheal wall thickness (ATWT) were obtained from POCUS, and the diameter of the subglottic and cervical trachea calculated using the radius of curvature (CR) formula. Results: A total of 123 volunteers without tracheal disease and 15 patients with SGS were enrolled. Both in control group and patients with SGS, there is a strong correlation between US-CR and CT-mean (r =0.96 and 0.98, P <0.001, respectively). The diameter of subglottic and cervical trachea assessed by US-CR is more accurate than the direct measurement of US-ACW. The intraobserver and interobserver repeatability of US-CR was excellent (all correlation coefficients > 0.95; P < 0.05). In patients with SGS, the degree of stenosis determined by US-ATWT correlate best with the CT-ATWT with coefficients of 0.98 (P<0.001), while a moderate correlation was observed between methods for ATWT (r = 0.65, P<0.001) in control group. Conclusion: The airway dimension measured using POCUS based on the radius of the curvature is a reliable tool for assessing the subglottic and cervical tracheal diameters.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"175 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136194597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validation of transthoracic shear-wave ultrasound elastography in diagnosing pleural lesions 经胸剪切波超声弹性成像诊断胸膜病变的验证

Ultrasound Pub Date : 2023-09-09 DOI: 10.1183/13993003.congress-2023.pa1831

Yao-Wen Kuo, Yen-Lin Chen, Huey-Dong Wu, Hao-Chien Wang

{"title":"Validation of transthoracic shear-wave ultrasound elastography in diagnosing pleural lesions","authors":"Yao-Wen Kuo, Yen-Lin Chen, Huey-Dong Wu, Hao-Chien Wang","doi":"10.1183/13993003.congress-2023.pa1831","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa1831","url":null,"abstract":"Purpose: This study used shear-wave ultrasound elastography to measure the stiffness of pleural lesions. The research hypothesis is that shear-wave elastography can add the elasticity information of the pleural lesions and help in the diagnosis of pleural diseases. Methods: This prospective observational study included one derivation cohort from May 2018 to Oct 2021 and one validation cohort from Nov 2021 to Aug 2022. The inclusion criterion was patients with radiographic evidence of pleural lesions or pleural effusion. We used the Toshiba Aplio 500 Platinum Ultrasound Machine to locate the pleural lesions and measure the elasticity of the pleural lesions. Diagnoses were made based on microbiological studies, pathology of pleural effusion or pleura, or following up the clinical course for at least 6 months. Results: A total of 210 patients with pleural lesions were included. The mean elasticity of the malignant pleural lesions was significantly higher than that of the benign pleural lesions (91.9 vs. 61.2 kPa, p< 0.001). Among the 103 patients in the derivation cohort, a receiver operating characteristic curve was constructed and the cut-off point to differentiate benign from malignant lesions was 60.2 kPa with an accuracy of 72.7% (sensitivity 81.3%, specificity 57.1%, and area under the ROC curve 0.69). Among the 107 patients in the validation cohort, the diagnostic performance was maintained with an accuracy of 73.8%. Conclusions: This study validated the use of shear-wave ultrasound elastography for assessing pleural malignancy. Additional studies using shear-wave elastography-guided pleural biopsy are warranted to further investigate the diagnostic yield.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136201209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Validity evidence of the 2022 ERS thoracic ultrasound Objective Structured Clinical Examination (OSCE) 2022年ERS胸部超声客观结构化临床检查(OSCE)的有效性证据

Ultrasound Pub Date : 2023-09-09 DOI: 10.1183/13993003.congress-2023.pa1814

Pia Iben Pietersen, Rahul Bhatnagar, Freja Andreasen, Lars Konge, Christian Laursen, Najib M. Rahman, Anders B. Nielsen

{"title":"Validity evidence of the 2022 ERS thoracic ultrasound Objective Structured Clinical Examination (OSCE)","authors":"Pia Iben Pietersen, Rahul Bhatnagar, Freja Andreasen, Lars Konge, Christian Laursen, Najib M. Rahman, Anders B. Nielsen","doi":"10.1183/13993003.congress-2023.pa1814","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa1814","url":null,"abstract":"Background: Clinicians increasingly use thoracic ultrasound in several settings due to its high diagnostic accuracy for many common causes of respiratory failure and dyspnoea. However, ultrasound examinations are operator-dependent, and sufficient competences are needed to obtain high diagnostic accuracy and to attain the ability to interpret the images and integrate them into the patient history and other examinations. This study aims to explore and gather validity evidence for the 2022 ERS thoracic ultrasound objective structured clinical examination (OSCE). Methods: An expert panel created the test, which included two theoretical and three practical stations comprising cases with diagnoses which can be established by point-of-care thoracic ultrasound. Twenty-five participants with different levels of experience thoracic ultrasound completed the test. Data from the test scores and questionnaires on participants’ experiences were used for item analysis. Validation was done according to Messick’s framework. The contrasting groups9 standard-setting method was used to establish a pass/fail score. Results: The summarised internal consistency reliability was high with a Cronbach’s alpha=0.83. The novice group (n=4) had a mean test score of 26.9±10.0 points, the intermediate group (n=8) scored 55.2±5.8 points, and the experienced group (n=13) 62.0±6.1 points (one-way ANOVA, p<0.001). A pass/fail score of 48 points was thus derived (maximum score =75 points). Conslusion: We developed a test for the assessment thoracic ultrasound competences with solid validity evidence, and a pass/fail standard with no false positives or false negatives.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136193688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Survey on lung ultrasound usage by portuguese pulmonologists 葡萄牙肺科医生肺部超声使用情况调查

Ultrasound Pub Date : 2023-09-09 DOI: 10.1183/13993003.congress-2023.pa1817

Bruno S. Silva, Beatriz Ferraz, Filipa Correia, Maria Inês Costa, Maria Esteves Brandão, Nuno Cortesão

{"title":"Survey on lung ultrasound usage by portuguese pulmonologists","authors":"Bruno S. Silva, Beatriz Ferraz, Filipa Correia, Maria Inês Costa, Maria Esteves Brandão, Nuno Cortesão","doi":"10.1183/13993003.congress-2023.pa1817","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa1817","url":null,"abstract":"Introduction: Lung ultrasound (LUS) performed by non-radiologist doctors has evolved over the last few decades, placing it as a useful diagnostic, prognostic and monitoring bedside tool in patients with respiratory disease. Despite its proven clinical applications, LUS training has not been standardized in Portugal. Objetctives: To characterize LUS learning processes and clinical usage amongst portuguese pulmonologists as well as to assess future needs. Methods: From August to November 2022 an online survey was sent to all members of the Portuguese Pulmonology Society. Degrees of confidence were assessed through Likert scales. Pearson’s chi-squared test and non-parametric tests were used. Outcomes were considered statistically significant if the probability of error was below 5% (p < 0.05). Results: 114 valid answers were obtained. Most responders (81%) had LUS training and 22% had attended other ultrasound-related courses. The majority had an ultrasound machine available. However, only 17% performed LUS > 3 times per week. Overall confidence in LUS usage for diagnostic purpose (median: 7/10), disease monitoring (median: 7/10) and support of invasive procedures (median: 8/10) were high. There was a significant relation between higher levels of confidence and regularly attending LUS courses and performing LUS > 3 times per week. The main reasons preventing regular use of LUS were availability/cost of courses, availability/cost of equipment and lack of time. Conclusions: Physician`s confidence degree on ultrasound utility is related to regular LUS training as well as regular usage. Costs involved with LUS training hamper its wider use.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136194438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quantitative US echogenicity to differentiate exudate from transudate pleural effusion 定量超声超声鉴别渗出液与渗出性胸腔积液

Ultrasound Pub Date : 2023-09-09 DOI: 10.1183/13993003.congress-2023.pa1825

Mona El Hoshy, Alaa Amin, Maged Hassan

{"title":"Quantitative US echogenicity to differentiate exudate from transudate pleural effusion","authors":"Mona El Hoshy, Alaa Amin, Maged Hassan","doi":"10.1183/13993003.congress-2023.pa1825","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa1825","url":null,"abstract":"Background: The echo-texture of pleural effusion (PE) can be determined by ultrasound (US) which gives a clue about its etiology. Echogenic PEs are usually due to exudates while anaechoic PEs can be transudate or exudate. This study aims to determine if quantitative measurement of PE echogenicity can non-invasively differentiate exudative from transudative PEs and to explore its correlation with PE biochemical and cellular content. Methods: The study prospectively recruited patients with PE US greyscale images were transferred to a computer to be analysed by an image analysis software. To control the sonographic window difference between patients, liver echogenicity was measured (using the same US settings image depth, gain, and focus position) and compared to that of PE. Pleural fluid relative echogenicity (PFRE) was calculated as the ratio of the PE echogenicity: liver echogenicity. Results: 54 patients were examined, 25males (46.3%) with mean age 52+15.7, exudates were (59%)). PE was due to malignancy in 17 cases, heart failure 9, liver cirrhosis 8, TB 7, empyema 6, Renal disease 5, inflammation 2. Exudates’ median LDH was 499 [298- 1388], Protein 4.2 [3.9- 4.8], and PFRE 0.51 [0.25 – 0.82].Transudates had a median LDH 74 [69-164], Protein 1.9 [1.5 – 2.8] and PFRE 0.24 [.09-.35]. PFRE significantly correlated with LDH (R 0.392, P=0.004) and serum protein (R 0.316, P=0.021). PFRE predicted PE nature with area under the curve for PFRE of 0.77[95%CI 0.64 -00.89]. A PFRE > 0.32 had a sensitivity of 70% and specificity of 74% to predict an exudate. Conclusion: PFRE can predict the nature of Pleural effusion (Exudates VS Transudates) non-invasively with moderate degree of accuracy.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136201017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diaphragmatic contraction speed at follow-up of patients admitted for myasthenia gravis 重症肌无力患者随访时膈肌收缩速度

Ultrasound Pub Date : 2023-09-09 DOI: 10.1183/13993003.congress-2023.pa1815

Santos Ferrer Espinosa, Antonio Quezada Reynoso, Jesus Sancho Chinesta, Juan Carbonell Asins, Jaime Signes-Costa Miñana

{"title":"Diaphragmatic contraction speed at follow-up of patients admitted for myasthenia gravis","authors":"Santos Ferrer Espinosa, Antonio Quezada Reynoso, Jesus Sancho Chinesta, Juan Carbonell Asins, Jaime Signes-Costa Miñana","doi":"10.1183/13993003.congress-2023.pa1815","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa1815","url":null,"abstract":"Myasthenic crisis (MC) is the most life-threatening complication of myasthenia gravis (MG). Our hypothesis is that repeated measures of the rate of diaphragmatic contraction (((v10-v1)/(v1))x100) after performing snip maneuvers using ultrasound can predict the need for mechanical ventilation in patients admitted for MG. 1 year duration prospective observational study. Patients who met admission criteria according to the Neurology Department with a diagnosis of MG and were evaluated by Pulmonology in the first 24 hours of admission were included. Demographic data, pulmonary function variables, and ultrasound data were collected. The percentage change between the first and tenth measurement of diaphragmatic contraction velocity were determined by this formula: (((v10-v1)/v1))x100). Statistical analysis: Wilcoxon test. 18 patients were included in the study. 52.9% were male with a mean age of 57.94 +/- 21.01 years. Demographic and clinical data are shown in Table 133.3% had a MC. The correlation between percentage change in diaphragmatic contraction velocity and snip and PImax were -0.593 (p=0.020) and -0.552 (p=0.041) respectively. After statistical analysis, we observed differences in (((v10-v1)/v1))x100) between the group of patients who required mechanical ventilation (and were classified as myasthenic crisis) vs the group of patients who did not require NIV (p= 0.0018). (figure 2) The percentage of change in diaphragmatic contraction velocity after repeated snip maneuvers may be an indicator of diaphragm fatigability in patients with MG and may be useful in determining the need for ventilation in these patients.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"368 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136195188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pleural irregularity and diaphragm mobility among patients with systemic sclerosis 系统性硬化症患者胸膜不规则和横膈膜活动

Ultrasound Pub Date : 2023-09-09 DOI: 10.1183/13993003.congress-2023.pa1818

Anja Ljilja Posavec, Boris Karanović, Ivana Ježić, Renata Huzjan Korunić, Nevenka Piskač Živković, Josip Tečer, Stela Hrkač, Joško Mitrović

{"title":"Pleural irregularity and diaphragm mobility among patients with systemic sclerosis","authors":"Anja Ljilja Posavec, Boris Karanović, Ivana Ježić, Renata Huzjan Korunić, Nevenka Piskač Živković, Josip Tečer, Stela Hrkač, Joško Mitrović","doi":"10.1183/13993003.congress-2023.pa1818","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa1818","url":null,"abstract":"Background: Pleural irregularity visualized by ultrasound has a higher specificity for interstitial lung disease (ILD) than B lines. It is manifested as a loss of the normal hyperechoic pleural contour. Diaphragm mobility has not been studied so far in patients with systemic sclerosis (SSc). Patients may have reduced diaphragm function due to ILD, disuse atrophy, malnutrition, corticosteroid therapy, etc. Aims and objectives: To investigate whether pleural irregularity is associated with diaphragm mobility in patients with SSc. Methods: In this cross sectional multicentric research participated 50 patients with systemic sclerosis. The patients underwent an ultrasound of the pleura. The mobility of the right diaphragm was measured in M mode with convex probe. We applied reference values for diaphragm mobility in deep breathing according to Boussuges et al. (1). Results: In patients with reduced mobility of the diaphragm in deep breathing, regression analysis pointed that irregular pleura on ultrasound was an independent factor predicting reduced diaphragm mobility (OR=40.0, 95% CI: 1.98 to 807.1). Conclusion: According to the results, irregular pleura on ultrasound is independent factor that predicts reduced mobility of the diaphragm in deep breathing among the patients with SSc. Literature: 1. Boussuges A, Gole Y, Blanc P. Diaphragmatic motion studied by m-mode ultrasonography: methods, reproducibility, and normal values. Chest 2009;135:391-400.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136200957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of Lung Ultrasound in detection and assessment of severity of ILD in patients with Systemic sclerosis 肺超声在系统性硬化症患者ILD严重程度的检测和评估中的作用

Ultrasound Pub Date : 2023-09-09 DOI: 10.1183/13993003.congress-2023.pa1821

Richa Gupta, Davis Joseph K J, Avinash Nair, John Mathew, Manisha Mane

{"title":"Role of Lung Ultrasound in detection and assessment of severity of ILD in patients with Systemic sclerosis","authors":"Richa Gupta, Davis Joseph K J, Avinash Nair, John Mathew, Manisha Mane","doi":"10.1183/13993003.congress-2023.pa1821","DOIUrl":"https://doi.org/10.1183/13993003.congress-2023.pa1821","url":null,"abstract":"ABSTRACT TITLE: Role of Lung Ultrasound in detection and assessment of severity of ILD in patients with Systemic sclerosis BACKGROUND: HRCT Thorax is gold standard for diagnosing ILD but has limitations because of cost and radiation exposure issues. Lung Ultrasound (LUS) has shown to be useful alternative for diagnosing ILD. AIM: To find out the diagnostic yield of Lung Ultrasound to detect ILD in patients with SSc-ILD. METHODS: All consecutive patients with Systemic sclerosis underwent HRCT, Pulmonary Function Test and Lung Ultrasound (LUS). LUS was done by chest physician who was blinded to the clinical, physiological, and radiological status of the patient. Presence of B-lines (number and sites)and broken pleura sign were recorded as sonographic features of ILD and correlated with the Warrick score in HRCT. RESULTS: A total of 117 patients (103 women) were included in the study. The number of B-lines detected on thoracic USG showed significant positive correlation with the Warrick score on HRCT (r=0.947;p<0.001). A significant relationship between presence of broken pleural sign in LUS and severity of Warrick score in HRCT was also found (p <0.001). With HRCT as the gold standard: the sensitivity, specificity, positive predicted value, and negative predicted value for LUS were found to be 100%, 98%, 98.9%, and 100% respectively. CONCLUSIONS: LUS is a good alternative to HRCT Thorax for early diagnosing of SSc-ILD. We propose LUS can be used as a screening tool for diagnosing lung interstitial involvement. It can also be used as a follow up tool to look for disease progression of ILD in patients with Systemic sclerosis.","PeriodicalId":23440,"journal":{"name":"Ultrasound","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136194283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0