The comet-tail artifact - An ultrasound sign of alveolar-interstitial syndrome
The comet-tail artifact - An ultrasound sign of alveolar-interstitial syndrome
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DOI：
10.1164/ajrccm.156.5.96-07096
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发表时间：
1997-11-01
影响因子：
24.7
通讯作者：
Barre, O
中科院分区：
文献类型：
--
作者：
Lichtenstein, D;Meziere, G;Barre, O
超声对肺泡间质综合征的诊断有帮助吗？在一项前瞻性研究中，我们对医疗重症监护室的250例连续患者进行了检查：121例有影像学肺泡-间质综合征（播散到全肺，n = 92；局部，n = 29）， 129例无影像学肺泡-间质综合征证据。超声检查胸壁前外侧。研究了从肺表面扇形散开的多个彗尾伪影的超声特征。在92例弥漫性肺泡间质综合征患者中，86例患者的肺表面均可见这种模式（敏感性为93.4%）。129例胸片正常的患者中，有120例未见或局限于最后外侧肋间隙（特异性为93.0%）。断层密度相关显示，胸膜下小叶间隔增厚，以及磨玻璃区，急性肺水肿的两个病变，与彗星尾伪影的存在有关。总之，彗星尾伪影的出现可以诊断肺泡间质综合征。
Can ultrasound be of any help in the diagnosis of alveolar-interstitial syndrome? In a prospective study, we examined 250 consecutive patients in a medical intensive care unit: 121 patients with radiologic alveolar-interstitial syndrome (disseminated to the whole lung, n = 92; localized, n = 29) and 129 patients without radiologic evidence of alveolar-interstitial syndrome. The antero-lateral chest wall was examined using ultrasound. The ultrasonic feature of multiple comet-tail artifacts fanning out from the lung surface was investigated. This pattern was present all over the lung surface in 86 of 92 patients with diffuse alveolar-interstitial syndrome (sensitivity of 93.4%). It was absent or confined to the last lateral intercostal space in 120 of 129 patients with normal chest X-ray (specificity of 93.0%). Tomodensitometric correlations showed that the thickened sub-pleural interlobular septa, as well as ground-glass areas, two lesions present in acute pulmonary edema, were associated with the presence of the comet-tail artifact. In conclusion, presence of the comet-tail artifact allowed diagnosis of alveolar-interstitial syndrome.