The 'double lung point': An ultrasound sign diagnostic of transient tachypnea of the newborn
The 'double lung point': An ultrasound sign diagnostic of transient tachypnea of the newborn
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DOI：
10.1159/000097454
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发表时间：
2007-01-01
期刊：
影响因子：
2.5
通讯作者：
Cattarossi, Luigi
中科院分区：
文献类型：
--
作者：
Copetti, Roberto;Cattarossi, Luigi
背景资料：新生儿短暂性呼吸急促（TTN）是新生儿呼吸窘迫的一种轻度形式，在其病程早期需要与其他严重呼吸系统疾病相鉴别。目前，诊断是基于放射学表现和临床过程。TTN的肺部超声检查尚未得到评估。目的：本研究的目的是确定TTN的超声表现，并评价其临床意义。方法：本文对32例有TTN影像学及临床表现的新生儿进行了肺超声检查，并与60例正常新生儿、29例呼吸窘迫综合征、6例肺炎、5例肺出血及5例肺不张进行了比较。结果：TTN患儿肺部超声表现为上、下肺回声不同。有非常紧凑的彗星尾伪影在较低的领域，而这些是罕见的上级领域。我们将这一发现命名为“双肺点”，在健康婴儿、呼吸窘迫综合征、肺不张、气胸、肺炎或肺出血婴儿中未观察到。双肺点诊断TTN的敏感性和特异性均为100%。结论：肺部超声检查对TTN的早期诊断是可靠的。我们认为，它应该成为新生儿呼吸窘迫成像的第一种方法，但需要进行进一步的前瞻性研究，良好的盲法。版权所有（c）2007 S. Karger AG，巴塞尔。
Background: Transient tachypnea of the newborn (TTN) is a mild form of neonatal respiratory distress which early in its course needs to be differentiated from other severe respiratory disorders. At present the diagnosis is based on radiological findings and clinical course. Lung sonography in TTN has not yet been assessed. Objectives: The aim of the study was to define the ultrasonographic appearance of TTN and evaluate its clinical relevance. Methods: Lung sonography was performed in 32 newborn infants with radiological and clinical signs of TTN within the first hour after birth and the findings were compared with those of 60 normal infants, 29 with respiratory distress syndrome, 6 with pneumonia, 5 with pulmonary hemorrhage and 5 with atelectasis. Results: In the infants with TTN, lung sonography showed a difference in lung echogenicity between the upper and lower lung areas. There were very compact comet-tail artifacts in the inferior fields while these were rare in the superior fields. We designated this finding the `double lung point' and it was not observed in healthy infants, infants with respiratory distress syndrome, actelectasis, pneumothorax, pneumonia, or pulmonary hemorrhage. Sensitivity and specificity of the double lung point was 100% for the diagnosis of TTN. Conclusion: We found lung sonography reliable for the early diagnosis of TTN. We suggest that it should become the first approach for imaging of neonatal respiratory distress although further prospective studies with good blinding need to be performed. Copyright (c) 2007 S. Karger AG, Basel.