Diagnostic Value of Bedside Lung Ultrasound and Chest CT on Subpleural Lesions and Lung Consolidation in ICU Patients with Severe Pneumonia.

Objective: To investigate the diagnostic value of bedside lung ultrasound and chest computed tomography (CT) for subpleural lesions and lung consolidation in intensive care unit (ICU) patients with severe pneumonia.

Methods: A retrospective selection was made of 100 ICU patients with severe pneumonia who were treated in our hospital from June 2020 to July 2024 as the research subject group. All patients underwent bedside lung ultrasound and chest CT examinations, and the CT imaging manifestations of the patients were observed. Using the CT examination results as the gold standard, the patients were divided into the lung consolidation group and non-lung consolidation group. The relevant data were collected and the clinical data of the two groups were observed. The positive predictive value, negative predictive value, specificity, sensitivity and accuracy of bedside lung ultrasound in the diagnosis of subpleural lesions and lung consolidation were analyzed.

Results: Chest CT showed that 73.00% of the patients had ≥2 lung lobes involved, mainly in the right lung (61.00%). 56.00% patients had 1-2 organs involved, mainly kidney (77.00%) or heart (87.00%). 69.00% of patients had pulmonary consolidation, 86.00% had bronchial shadow, and 82.00% had mass, patchy or nodular shadow. Compared with the non-lung consolidation group, the lung ultrasound score of the lung consolidation group was significantly increased (P<0.05), and the proportion of lung parenchyma, the number of subpleural lesions and the number of pleural intercostal changes were significantly increased (P<0.05). The consistency test showed that bedside ultrasound had a high consistency with chest CT in the diagnosis of subpleural lesions and lung consolidation (Kappa=0.678, P<0.05; Kappa=0.743, P< 0.05).

Conclusion: Bedside lung ultrasound and chest CT had a high consistency in the diagnosis of subpleural lesions and lung consolidation, which may be used as an important method to judge the development of severe pneumonia in ICU.