儿童清醒状态下喉部超声检查的初步可行性研究

文献信息

中文摘要

背景： 柔性鼻喉镜检查是喉部评估的金标准检查，但可能使儿童感到不适、耐受性差甚至拒绝。超声检查无创且耐受性良好，可能提供一种替代方法。然而，儿童中的数据稀缺。
目的： 评估在诊室中使用参考成像平面对儿童进行超声检查以识别喉部结构的可行性，并确定影响检查质量的因素。
材料和方法： 在0至15岁儿童中开展了一项单中心、非干预性、前瞻性诊断工具初步可行性研究。超声图像由操作者和第二位设盲观察者使用录制序列进行评估。定性数据和评分者间一致性以百分比表示。通过逻辑回归评估关联性，显著性阈值设为1%。
结果： 共纳入140名儿童。5个超声平面——轴位声门、声门下和气管，以及矢状位正中线和旁正中线——在两位评估者中均能在超过95%的病例中显示甲状软骨、环状软骨和杓状软骨以及声带活动度。年龄和性别影响在评估者之间有所不同，而BMI未显示显著影响。无后方声影的钙化灶未干扰结构分析。
结论： 我们证明了使用5个参考平面进行儿童喉部超声检查的可行性，能够显示喉部结构，无论是否存在钙化。

英文摘要

BACKGROUND: Flexible nasal laryngoscopy is the gold standard examination for laryngeal assessment, but can be uncomfortable, poorly tolerated or even refused by children. Ultrasonography is non-invasive and well-tolerated and could provide an alternative. Data in children, however, are scarce.
AIMS: To assess the feasibility of in-office ultrasonography in children for the identification of laryngeal structures using reference imaging planes, and to determine factors influencing examination quality.
MATERIAL AND METHODS: A single-center non-interventional prospective pilot feasibility study of a diagnostic tool was conducted in children aged 0 to 15 years. Ultrasonographic images were evaluated by the performing operator and by a second blinded observer using recorded sequences. Qualitative data and inter-rater agreement were expressed as percentages. Association was assessed by logistic regression, with the significance threshold set at 1%.
RESULTS: One hundred and forty children were included. The 5 ultrasound planes - axial glottic, subglottic and tracheal, and sagittal median and paramedian - allowed visualization of the thyroid, cricoid and arytenoid cartilage and vocal fold mobility in more than 95% of cases for both assessors. Age and gender effects differed between assessors, while BMI showed no significant effect. Calcification foci, without posterior acoustic shadowing, did not interfere with structural analysis.
CONCLUSION: We demonstrated the feasibility of pediatric laryngeal ultrasonography using 5 reference planes, enabling visualization of laryngeal structures regardless of calcifications.