| 摘要: |
| ［摘要］ 目的 分析新生儿肺脏常见疾病的肺脏超声（LUS）声像图特征。方法 招募2018年3月至2024年1月于昆明医科大学附属德宏医院（德宏州人民医院）出生的疑似罹患肺脏疾病的新生儿466例，均接受胸部X线和LUS检查，两种检查时间间隔≤15 min，结合临床表现，两种检查诊断结果一致。归纳和总结不同类型新生儿LUS声像图特征。结果 466例新生儿中新生儿暂时性呼吸增快症（TTN）88例，新生儿呼吸窘迫综合征（NRDS）69例，新生儿急性呼吸窘迫综合征（ARDS）29例，胎粪吸入综合征（MAS）57例，新生儿肺炎（NP）89例，新生儿肺出血（NPH）6例，支气管肺发育不良（BPD）20例，新生儿肺不张3例，新生儿气胸8例，非肺部疾病新生儿97例。新生儿正常肺脏的LUS声像图特征：胸膜线和A-线无异常，肺滑存在；M型超声表现为沙滩征；无肺泡-间质综合征（AIS）、致密B-线、白肺和肺实变；可存在B-线/彗星尾征。TTN的LUS声像图特征：具备胸膜线异常、A-线异常、沙滩征；具备AIS/致密B-线/白肺、双肺点、B-线/彗星尾征中的一项或多项；可具备肺岛、胸腔积液。NRDS、ARDS、MAS、NP、NPH、BPD的LUS声像图特征：具备肺实变、碎片征、磨玻璃征、雪花征、肺搏动、沙滩征之一；可具备B-线/彗星尾征、AIS/致密B-线/白肺、双肺点、胸膜线异常、A-线异常、胸腔积液；共同点为存在LUS影像学的肺实变。新生儿肺不张的LUS声像图特征为肺实变，但是未观察到双肺点、胸腔积液。新生儿气胸的LUS声像图特征：具备肺滑异常、平流层征，可有肺点。结论 LUS可用于新生儿肺脏常见疾病的检查和诊断，但同一疾病可同时存在多个声像图特征，而同一声像图特征也可能提示不同的疾病，临床医师需要结合患儿的临床表现及其他检查结果进行诊断。 |
| 关键词: 新生儿 肺脏疾病 肺脏超声 声像图特征 |
| DOI：10.3969/j.issn.1674-3806.2025.04.12 |
| 分类号:R 722.1 |
| 基金项目:云南省科技厅科技计划项目（编号：202201AY070001-220）；国家自然科学基金项目（编号：81960290）；云南省教育厅科学研究基金项目（编号：2019J1316）；德宏州科技计划项目（编号：zc202411，zc202410）；德宏州人民医院科学研究基金项目（编号：2022DY008）；德宏州中青年学术和技术带头人后备人才培养（英才兴边计划）项目（编号：2023RC001） |
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| Analysis on characteristics of lung ultrasound images of common lung diseases in newborns |
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FENG Zaili1,2, YANG Mingjie3, HUANG Na1,2,4, ZHANG Meiling2, XU Fang5, DUAN Shengluan5, LI Rui2, GUO Yunhua3
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1.Graduate School, Kunming Medical University, Kunming 650000, China; 2.Department of Neonatology, Dehong Hospital Affiliated to Kunming Medical University(Dehong Prefecture People′s Hospital), Mangshi 678400, China; 3.Department of Imaging Medicine, Dehong Hospital Affiliated to Kunming Medical University(Dehong Prefecture People′s Hospital), Mangshi 678400, China; 4.Clinical College, Dehong Vocational College, Mangshi 678400, China; 5.Department of Obstetrics, Dehong Hospital Affiliated to Kunming Medical University(Dehong Prefecture People′s Hospital), Mangshi 678400, China
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| Abstract: |
| ［Abstract］ Objective To analyze the characteristics of lung ultrasound(LUS) images of common lung diseases in newborns. Methods A total of 466 newborns with suspected lung diseases who were born in Dehong Hospital Affiliated to Kunming Medical University(Dehong Prefecture People′s Hospital) from March 2018 to January 2024 were recruited. The newborns received both chest X-ray examination and LUS examination, with the time interval between the two examinations equal to or less than 15 minutes. Based on clinical manifestations, the diagnostic results of the two examinations were consistent. The characteristics of LUS images in different types of newborns were concluded and summarized. Results Among the 466 newborns, there were 88 cases of transient tachypnea of newborn(TTN), 69 cases of neonatal respiratory distress syndrome(NRDS), 29 cases of neonatal acute respiratory distress syndrome(ARDS), 57 cases of meconium aspiration syndrome(MAS), 89 cases of neonatal pneumonia(NP), 6 cases of neonatal pulmonary hemorrhage(NPH), 20 cases of bronchopulmonary dysplasia(BPD), 3 cases of neonatal pulmonary atelectasis, 8 cases of neonatal pneumothorax, and 97 case of non-pulmonary diseases. The characteristics of LUS images of normal lungs in newborns: no abnormalities in pleural line and A-line, presence of lung slippage; manifestation of beach sign in M-mode ultrasound; absence of alveolar-interstitial syndrome(AIS), dense B-line, white lung and lung consolidation; possible B-line/comet-tail sign. The characteristics of LUS images of TTN: having abnormality in pleural line, abnormality in A-line, beach sign; having one or more than one feature of AIS/dense B-line/white lung, bipulmonary dots, B-line/comet-tail sign; possible lung islands and pleural effusion. The characteristics of LUS images of NRDS, ARDS, MAS, NP, NPH and BPD: having one of the manifestations of lung consolidation, fragment sign, ground-glass sign, snowflake sign, pulmonary pulsation and beach sign, and having the possible features of B-line/comet-tail sign, AIS/dense B-line/white lung, bipulmonary dots, abnormality in pleural line, abnormality in A-line and pleural effusion; and having the common manifestation of lung consolidation in LUS images. The LUS images of neonatal pulmonary atelectasis were manifested as lung consolidation, but no bipulmonary dots and pleural effusion were observed. The characteristics of LUS images of neonatal pneumothorax: presence of abnormality in lung slippage, stratosphere sign and possible bipulmonary dots. Conclusion LUS can be used for the examination and diagnosis of common lung diseases in newborns. However, the same disease may have multiple characteristics of ultrasound images simultaneously, and the same characteristics of ultrasound images may also indicate different diseases. Clinicians should make the diagnosis for the newborn patients based on their clinical manifestations in combination with other examination results. |
| Key words: Newborns Lung diseases Lung ultrasound(LUS) Characteristics of ultrasound images |
