超声造影联合穿刺活检在肺周围型病变定性诊断中的应用

发布时间：2018-06-18 12:57

本文选题：超声检查 + 时间强度曲线　；参考：《中国介入影像与治疗学》2017年05期

【摘要】：目的探讨CEUS联合穿刺活检在肺周围型病变定性诊断中的应用价值。方法对158例肺周围型病变患者行经皮穿刺活检术,其中97例术前行CEUS检查(试验组),61例术前仅行常规超声检查(对照组)。比较两组穿刺次数、诊断阳性率及并发症情况。绘制CEUS时间-强度曲线(TIC),比较试验组中良性与恶性病变TIC的上升时间(RT)、达峰时间(TTP)、曲线上升斜率(WIS)及峰值强度(PI)。观察并记录良恶性病变的增强特征。结果试验组和对照组穿刺病理诊断阳性率分别为94.85%(92/97)和83.61%(51/61),差异有统计学意义(P=0.02);平均穿刺次数分别为(2.11±0.48)次和(2.20±0.44)次,两组间差异无统计学意义(P=0.18);并发症发生率分别为2.06%(2/97)和4.92%(3/61),差异无统计学意义(P=0.32)。RT、WIS及PI在良恶性病变间差异有统计学意义(P均0.05),TTP差异无统计学意义(P=0.08)。试验组良恶性病变均以不均匀增强为主,良性病变中占77.50%(31/40),恶性病变中占88.46%(46/52),其增强特征差异无统计学意义(P=0.16)。结论 CEUS在肺周围型病变的定性诊断中具有一定价值,对经皮肺穿刺活检具有指导意义。
[Abstract]:Objective to evaluate the value of CEUs combined with biopsy in qualitative diagnosis of peripheral pulmonary lesions. Methods Percutaneous puncture biopsy was performed in 158 patients with peripheral pulmonary lesions, of which 97 cases underwent CEUs before operation, while 61 cases in the test group received routine ultrasound examination before operation (control group). The times of puncture, positive rate of diagnosis and complications were compared between the two groups. The time intensity curve of CEUS was drawn to compare the rising time of TIC with that of benign and malignant lesions in the test group. The peak time of TIC and the peak value of TIC were compared. The peak intensity of TIC and the peak intensity of TIC were compared with those of the control group. The contrast-enhanced features of benign and malignant lesions were observed and recorded. Results the positive rate of puncture pathological diagnosis in the test group and the control group was 94.85 / 92 / 97) and 83.61% respectively, the difference was statistically significant (P < 0.01), the average puncture times were 2.11 卤0.48 times and 2.20 卤0.44 times, respectively. There was no significant difference in the incidence of complications between the two groups (2.06 / 97) and 4.92 / 3 / 61 (P < 0.05). There was no significant difference between the two groups (P < 0.01). There was no significant difference between the two groups (P < 0.01). There was no significant difference in TTP between benign and malignant lesions (P = 0.05) and there was no significant difference in TTP between the two groups (P = 0.08). The benign and malignant lesions in the test group were mainly enhanced inhomogeneously. The proportion of benign lesions was 31.40%, and that of malignant lesions was 88.46% / 52%. There was no significant difference in the enhancement characteristics between benign and malignant lesions (P = 0.16). Conclusion CEUs has certain value in qualitative diagnosis of peripheral pulmonary lesions, and has guiding significance for percutaneous lung biopsy.
【作者单位】：兰州大学第二医院超声科;
【分类号】：R445.1;R563

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