肺超看到肺点一定是气胸你的知识点要更新了

Lungpointintheabsenceofpneumothorax

来源：IntensiveCareMedicine

Givenareported%specificityforthediagnosisofpneumothorax,thelungpointhasbeenconsideredasignthatcannotbemimicked.However,wenowpresentauniquecaseofthepresenceoflungpointintheabsenceofpneumothoraxina75-year-oldmanadmittedaftercoronaryarterybypassgraft(图1).

图1

aLungpoint.Theyellowarrowshowswherelungslidingwasabsent.AsingleB-line,markedbytheyellowasterisk,waspresentintheabsenceoflungsliding.Thegreenarrowshowswherelungslidingwaspresent.

bTheM-modeofthelungpointwheretheimmobilityoftheaffectedlungalternateswiththemovementofthehealthylungwhichcanbeobservedintheM-modeasstratospheresign(yellowasterisk)alternatingwithseashoresign(greenasterisk)respectively.

cPost-operationalchestX-rayshowingpleuralthickening.

dThoracicCTscanshowingpre-existentasbestos-relatedpleuraldisease.TheredarrowsontheCTandX-rayindicatepleuralthickeningandcalcification[胸膜增厚及钙化]

Scanningattherightanteriorthirdintercostalspaceshowedabsenceoflungsliding(视频A),A-lineandstratospheresignindicatinganA′-profile.

视频A

Thus,alungpointwasactivelysearchedforandindeedfound.PneumothoraxwasruledoutbythepresenceofaB-lineinthesameviewasthelungpoint(视频B),apost-operativechestX-rayandCTscanwhichindicatedthepre-existenceofasbestos-relatedpleuraldisease(图.1a,c,d).Wepostulatethatthehealthypartofthelungmovesunrestrictedlywhereastheaffectedpartisrestricted,theirtransitionresultinginalungpoint.Anothersituationwherelungpointmaybefalsepositiveisa‘bleb’pointinbullouslungdisease.

视频B

Inconclusion,absentlungslidingandlungpointcanbeobservedincasesofpleuralthickeningandadhesionandmaythuswarrantrevisionoftheperceptionthatlungpointispathognomonic(特征，能确定诊断的意思)forpneumothorax.

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胸膜增厚及粘连时也可以出现肺点伴肺滑行消失。

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