ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2017-2-47-59ssmu-875Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEW AND LECTURESУльтразвуковое исследование легких при пневмонииUltrasound examination of pneumonia-infected lungsЧуяшенкоЕ. В.ChuyashenkoElena V.

аспирант

634050, г. Томск, Московский тракт, 2 

Рostgraduate Student

2, Moscow Tract, 634050, Tomsk

chuyashenko.lena@mail.ruЗавадовскаяВ. Д.ZavadovskayaVera D.

д-р мед. наук, профессор, зав. кафедрой лучевой диагностики и лучевой терапии

634050, г. Томск, Московский тракт, 2 

DM, Professor, Head of the Department of Radiation Diagnostics and Radiation Therapy

2, Moscow Tract, 634050, Tomsk

АгееваТ. С.AgeevaTatyana S.

д-р мед. наук, профессор, зав. кафедрой госпитальной терапии

634050, г. Томск, Московский тракт, 2 

DM, Professor, Head of the Department of Hospital Therapy

2, Moscow Tract, 634050, Tomsk

ПросекинаН. М.ProsekinaNataliya M.

канд. мед. наук, врач-высшей категории ультразвуковой диагностики

634050, г. Томск, Московский тракт, 2 

PhD, Higher Doctor of Ultrasound Diagnosis

2, Moscow Tract, 634050, Tomsk

ПероваТ. Б.PerovaTatyana B.

канд. мед. наук, доцент кафедры лучевой диагностики и лучевой терапии

634050, г. Томск, Московский тракт, 2 

PhD, Аssоciate Professor, Department of the Radiation Diagnostics and Radiation Therapy

2, Moscow Tract, 634050, Tomsk

Сибирский государственный медицинский университет (СибГМУ)РоссияSiberian State Medical University (SSMU)Russian Federation2017120720171624759Copyright © Чуяшенко Е.В., Завадовская В.Д., Агеева Т.С., Просекина Н.М., Перова Т.Б., 20172017Чуяшенко Е.В., Завадовская В.Д., Агеева Т.С., Просекина Н.М., Перова Т.Б.Chuyashenko E.V., Zavadovskaya V.D., Ageeva T.S., Prosekina N.M., Perova T.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/875

В последние десятилетия широко обсуждается диагностическая информативность ультразвука при многочисленном спектре заболеваний органов грудной клетки (пневмония, периферические объемные образования, заболевания плевры, пневмоторакс). Преимущества ультразвукового исследования – отсутствие лучевой нагрузки, получение изображения в реальном времени, отчетливая визуализация субплевральных отделов легких и реберно-диафрагмальных синусов – дают возможность использовать ультразвук в педиатрической практике для частого мониторирования динамики пневмонии. Применение ультразвукового исследования в диагностическом алгоритме у пациентов взрослого контингента с пневмонией в отечественной клинической практике широко не используется.

В статье подробно излагаются методика ультразвукового исследования органов грудной клетки, ультразвуковая анатомия, ультразвуковая картина в зависимости от морфологического субстрата патологического образования, его локализации, протяженности.

Представлен обзор библиографических данных об ультразвуковой семиотике пневмоний в зависимости от типа воспалительного инфильтрата (гипо-и гиперэхогенные структуры различной формы, протяженности, артефакты, А-линии, В-линии). Обоснована необходимость использования ультразвука для мониторирования течения пневмонии с целью оценки эффективности терапии.

Указано, что до настоящего времени не раскрыты полностью возможности ультразвукового исследования в зависимости от морфологической формы воспаления, нет данных о сопоставлении ультразвукового исследования, рентгенографии и компьютерной томографии. Не установлена периодичность ультразвукового мониторирования воспалительных заболеваний легких.

Ввиду безопасности и широкой доступности метода в сочетании с использованием режима цветного допплеровского картирования ультразвуковое исследование может занять надлежащее место в алгоритме лучевой диагностики у больных воспалительными заболеваниями легких. 

In the last few decades the content of diagnostic information provided by ultrasound examination of the chest in a wide spectrum of diseases (pneumonia, peripheral tumors, pleural diseases, pneumothorax) has been widely discussed. The advantages of ultrasound examination (the lack of radiation exposure, image in real time, the distinct visualization of pulmonary subpleural portions and costal diaphragmatic sinuses) provide the possibility to use ultrasound in pediatric practice for frequent monitoring of pneumonia dynamics. The use of ultrasound examination in the diagnostic algorithm in adult patients with pneumonia is not widely used in Russian clinical practice.

The article gives the details about the technique of ultrasound examination of the chest, ultrasound anatomy, the impact of the morphological substrate of the pathological formation on the ultrasound picture, and its localization and length. The review of bibliography data about ultrasound semiotics of pneumonia depending on the type of inflammatory infiltrate (hypo and hyperechoic structure of various shapes, length, artifacts, A-line, -line). The necessity of ultrasound use for monitoring pneumonia in order to assess the therapy efficacy has been proven (this is a very strong statement, I would say it “has been supported”.

It is indicated that the possibility of ultrasound examination depending on morphological forms of inflammation has not been disclosed and there are no data about the comparison of ultrasound, X-ray and computed tomography. The recommended frequency of the ultrasound monitoring of different inflammatory lung diseases has not yet been determined (this makes it sound like there are no results).

This article indicates that ultrasound examination can take its important place as an option in the diagnosis in patients with inflammatory lung diseases due to the safety and wide availability of this method in combination with the CDK. 

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The authors declare that there are no conflicts of interest present.