Background:Pleural effusion (PE) is a frequent complication in patients with malignancies and is often associated with poor prognosis. Lung ultrasound (LUS) has become an indispensable bedside tool for detecting, characterizing, and guiding the management of pleural effusions.Methods:This narrative review summarizes the current evidence on the diagnostic performance of LUS for PE in cancer patients, emphasizing recent advances in functional ultrasound techniques.Results:B-mode LUS can detect small-volume effusions and estimate their volume. Sonographic features such as echogenicity, septations, and pleural abnormalities can help differentiate transudative from exudative effusions. Shear-wave elastography and contrast-enhanced ultrasound provide additional functional information on tissue stiffness and perfusion. This information may help distinguish between malignant and benign pleural lesions and facilitate targeted biopsy when cytology is nondiagnostic. Compared with computed tomography, LUS offers superior evaluation of juxtadiaphragmatic and pleural surface abnormalities. It facilitates safe, real-time thoracocentesis. Recent innovations, including improved quality, affordable handheld ultrasound systems and artificial intelligence-based analysis, are expected to further enhance diagnostic precision and accessibility.Conclusions:Although LUS is a sensitive and versatile tool for assessing PE in cancer patients, it has limited diagnostic accuracy in distinguishing between benign and malignant effusions. Advanced techniques, such as shear-wave elastography and contrast-enhanced ultrasound, may further support the differentiation of malignant and benign diseases. Ongoing technological advances are likely to enhance the diagnostic accuracy and accessibility of lung ultrasound.
背景：胸腔积液是恶性肿瘤患者的常见并发症，常与不良预后相关。肺部超声已成为床边检测、表征及指导胸腔积液管理不可或缺的工具。 方法：本叙述性综述总结了当前关于肺部超声在癌症患者胸腔积液诊断性能的证据，重点介绍了功能性超声技术的最新进展。 结果：B型超声可检测少量积液并评估其体积。超声特征如回声性、分隔及胸膜异常有助于区分漏出性与渗出性积液。剪切波弹性成像和超声造影可提供组织硬度和灌注的额外功能信息，这些信息有助于区分良恶性胸膜病变，并在细胞学检查无法确诊时辅助靶向活检。与计算机断层扫描相比，肺部超声在评估膈肌旁及胸膜表面异常方面更具优势，并能实现安全、实时的胸腔穿刺术。近期技术革新，包括质量提升、价格亲民的手持式超声系统及基于人工智能的分析方法，有望进一步提高诊断精确度和可及性。 结论：尽管肺部超声是评估癌症患者胸腔积液的敏感且多功能的工具，但其在区分良恶性积液方面的诊断准确性有限。剪切波弹性成像和超声造影等先进技术可能进一步支持良恶性疾病的鉴别。持续的技术进步有望提升肺部超声的诊断准确性和临床可及性。
肿瘤(癌症)患者之家