李琪,聂芳,杨丹,汪延芳,李静.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[J].中国介入影像与治疗学,2017,14(5):274-277
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
Application of contrast enhanced ultrasound combined biopsy in qualitative diagnosis of peripheral pulmonary lesions
投稿时间:2016-09-25  修订日期:2017-03-08
DOI:10.13929/j.1672-8475.201609035
中文关键词:  超声检查  时间强度曲线  活组织检查  肺周围型病变
英文关键词:Ultrasonography  Time intensity curve  Biopsy  Pulmonary disease
基金项目:
作者单位E-mail
李琪 兰州大学第二医院超声科, 甘肃 兰州 730030  
聂芳 兰州大学第二医院超声科, 甘肃 兰州 730030 fang-nie@163.com 
杨丹 兰州大学第二医院超声科, 甘肃 兰州 730030  
汪延芳 兰州大学第二医院超声科, 甘肃 兰州 730030  
李静 兰州大学第二医院超声科, 甘肃 兰州 730030  
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中文摘要:
      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。
英文摘要:
      Objective To investigate the application value of CEUS combined with biopsy in qualitative diagnosis of peripheral pulmonary lesions. Methods A total of 158 patients with peripheral pulmonary lesions underwent percutaneous puncture biopsy. Among them, 97 cases underwent CEUS before biopsy (experiment group), and 61 cases underwent conventional ultrasound (control group). Puncture times, positive rate of samples pathological diagnosis and occurrence rate of complications were compared between the two groups. The time intensity curve (TIC) was used to obtain the rise time (RT), time to peak (TTP), wash-in slope (WIS) and peak intensity (PI). The parameters of TIC between the two groups were compared. The enhanced morphology of lesions was also observed and recorded. Results The positive rate of samples pathological diagnosis was 94.85% (92/97) in experiment group and 83.61% (51/61) in control group. The difference of the positive rate was significant between the two groups (P=0.02). In experiment and control group, the average puncture times were 2.11±0.48 and 2.20±0.44; While the occurrence rate of complications were 2.06% (2/97) and 4.91% (3/61). No significant difference was found of the average puncture times and the occurrence rate of complications between the two groups (both P>0.05). While the statistical differences of RT, PI and WIS were found between benign and malignant lesions (all P<0.05) in experiment group. And no statistical difference of TTP was found (P=0.08). Totally 77.50% (31/40) of the benign lesions showed inhomogeneous enhancement, while the proportion was 88.46% (46/52) in malignant lesions. There was no statistical difference of enhanced morphology between benign and malignant lesions (P=0.16). Conclusion CEUS is helpful in distinguishing benign and malignant peripheral pulmonary lesions. And it has great value in guiding percutaneous biopsy in peripheral pulmonary lesions.
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