Ultrasonograplly of Chest Diseases: Analysis of 154 Cases

超音波在胸部疾病之運用比其他疾病之範圍少很多，主要是由於肋骨及肺內空氣對超音波之干擾，胸部疾病必需具備週邊性及不透明性，方能使用超音波檢查。超音波檢查在胸部疾病之運用，常見的為肋膜病變、腫瘤、肺萎陷、肺炎、肺膿瘍、縱膈腔腫瘤、鄰近橫膈病變等。本文對154例各種胸部疾病的超音波影像特徵，做一般化之歸類與分析，俾讓讀者對胸部疾病超音波影像之基本概念有所了解，以期胸部超音波之運用能更普遍。154例之最後診斷為：正常為10例；肺膿瘍為10例；肺炎為31例；腫瘤為24例；阻塞性肺氣不張為11例；肋膜併心包膜積水為8例；輕度肋膜積水為10例；肋膜粘黏為6例；大量肋膜積水併單純性肺氣不張為32例；肺炎併肋膜積水為12例。各種不同疾病的超音波影像特徵為：(1)正常者為均勻高密度帶狀超音波聚集在胸壁下，橫膈膜線看不見。(2)肺膿瘍為拱型或圓型狀壁，內部超音波具異質性。(3)肺炎為不規則邊緣，內部超音波的異質性，空氣氣管影像時常可見。(4)阻塞性肺氣不張為平順邊緣，均勻同質性內部超音波。(5)腫瘤為平順邊緣，多種內部音波差異。(6)肋膜併心包膜積水為可見心包膜及心臟及肺臟在空腔內搏動。(7)輕度助膜積水為可見橫隔膜腺。(8)肋膜粘黏為線狀高密度超音波聚集在胸壁下。(9)單純壓泉性肺萎陷為平順邊緣，均勻高密度內部超音波。(10)肺炎併肋膜積水為肺臟之超音波影像與一般肺炎者相似。在超音波影像上空氣氣管影像常見於肺炎，此點可用以鑑別診斷。阻塞性肺萎陷、腫瘤、肺炎及包被的肋膜積水，四者在胸部X光上有時難以區別，利用超音波影像來區別此四者大致容易多了。超音波影像在某些病變可輔助胸部X光作進一步的判讀，而且費用此電腦斷層攝影便宜很多。

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並列摘要

Sonographic characteristics of various chest diseases in 154 cases were analysed according to margin of the lesion, internal echogenecity, posterior echo enhancement, air bronchogram etc. We in tended to present the basic sonographic patterns of common chest dieases. The study included 10 normal cases, 10 cases with lung abscesses, 31 cases of pneumonia, 24 cases of tumors, 11 cases of obstructive atelectasis, 6 cases with pleural thickening, 32 cases of massive pleural effusion with simple compression atelectasis and 12 cases of pneumonia with parapneumonic effusion. Sonographically, normal lung showed hyperechoic zone beneath the chest wall. Identification of arc or ring-shaped wall favored lung abscess. Air bronchogram could only be found in pneumonia. Mass showed various internal echogenecity. The internal echogenecity in obstructive atelectasis was very homogeneous which could not be found in tumor. Pleural thickening showed linear hyperechogenecity beneath the chest wall. In minimal effusion, The line of the diaphragm could be easily identified. Pleuropericardial effusion could be easily diagnosed by chest sonography. The line of the pericarcadium could be clearly identified. The internal echogenecity of massive effusion were various. The internal echogenecity of simple compression atelectasis showed very homogeneous hyperdense internal echogenecity. The internal echogenecity of lung parenchyma in pneumonia with parapneumonic effusion was similar to that of pneumonia. Obstructive atelectasis, mass, consolidation and encapsulated effusion could be differentiated by chest sonography without much difficulty. Sonography could aid chest radiography by giving more morphologic information and was cheaper than computed tomography.

並列關鍵字

chest ultrasonography

國際替代計量

Ultrasonograplly of Chest Diseases: Analysis of 154 Cases

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