肺エコー

-- Views

September 12, 22

スライド概要

profile-image

見習い芸人

シェア

埋め込む »CMSなどでJSが使えない場合

各ページのテキスト
1.

⼼不全御法度

3.

BLUE-Protocol • the bedside lung ultrasound in emergency (BLUE)-protocol for the immediate diagnosis of acute respiratory failure FALLS-Protocol • the fluid administration limited by lung sonography (FALLS)protocol for the management of acute circulatory failure

4.

⽤語 • BLUE: bedside lung ultrasound in emergency • FALLS: fluid administration limited by lung sonography • LUCI: lung ultrasound in the critically ill • LUCIFLR: Lung Ultrasound in the Critically Ill Favoring Limitation of Radiation • PLAPS: posterolateral alveolar and/or pleural syndrome

5.

10個のサインをマスターしよう • normal lung surface (bat sign, lung sliding, A-lines) • pleural effusions (quad and sinusoid sign) • lung consolidations (fractal and tissue-like sign) • interstitial syndrome (lung rockets) • pneumothorax (stratosphere sign and the lung point)

6.

upper BLUE-point lower BLUE-point PLAPS-point

7.

正常 normal lung surface

8.

肋⾻ bat sign 胸膜 A-line A-line: 胸膜の下に ガスがある

9.

bat sign A-line comet-tail artifact seashore sign of lung sliding

10.

胸⽔ pleural effusions

11.

quad sign 狭義のPLAPS rib shadows pleural line lung line(臓側胸膜) rib shadows sinusoid sign︓呼吸でpleural line とlung lineが⼀緒に動く=被包化 されおらず、粘度が低い胸⽔ long comet-tail artifact (sub-B-line) long comet-tail artifact︓接してい る肺に含気あり(=consoliation なし)

12.

硬化像 lung consolidations

13.

shred sign pleural line lung line(臓側胸膜) nontranslobar consolidation 病変はlung lineと gas barriersの間 shredded deep border( gas barriers ) これもPLAPS

14.

translobar consolidation pleural line tissue-like sign これもPLAPS

15.

interstitial syndrome

16.

lung rockets septal rockets ground glass rockets lung rockets 2つの肋⾻間に3本以上のB lineがある。 B line特徴 必須条件︓胸膜から⽣じる。lung slidingと⼀ 緒に動く 95%認める︓⻑くスクリーンの端まである。 A lineを消す。pleural lineくらい⾼輝度 septal rockets 肋⾻間に3、4本のB line ⼩葉間隔壁の肥厚(通常は浮腫) ground glass rockets 肋⾻間にseptal rocketsの2倍程度のB line CTのすりガラス影領域に⼀致

17.

気胸 pneumothorax

18.

M-mode pleural line pleural line A-line Aʼ- profile︓A-line(+)、lung sliding(-) 気胸に対し感度は⾼いが特異度は⾼くな い。 stratosphere sign (成層圏サイン)

19.

pleural line lung point

20.

A-profile: A-line優位 Aʼ-profile: A-line優位+ lung sliding消失 B-profile: B-line優位 Bʻ-profile: B-line優位+ lung sliding消失 C-profile: 硬化像

24.

資料