超声造影对周围型肺癌的鉴别诊断价值  

Identification value of contrast-enhanced sonography on peripheral pulmonary cancer

作　　者：陈蓓蕾[1] 黄品同[3] 叶风[1] 陈利民[1] 黄佩甄[1] 贺军[1] 柳刚[1] 蒋贤高[2] 

机构地区：[1]温州市第二人民医院超声科,325000 [2]温州市第二人民医院感染科,325000 [3]浙江大学医学院附属第二医院超声科

出　　处：《中华超声影像学杂志》2012年第2期124-127,共4页Chinese Journal of Ultrasonography

摘　　要：目的 探讨超声造影技术在周围型肺癌鉴别诊断中的应用价值.方法 选取周围型肺部病变患者59例,其中原发性肺癌组27例,非肺癌组32例（包括肺脓肿12例,结核球19例,血管瘤1例）.先行常规超声检查记录病灶的形态、边界、回声特点、血流情况,然后行超声造影检查记录超声造影增强模式和声学定量分析参数,最后行手术或穿刺活检取得病理结果.结果 在血流检出率方面,超声造影明显优于彩色多普勒超声,差别有统计学意义（P＜0.01）.在声学定量分析方面,肺癌组峰值强度（PI）和增强强度（EI）明显高于非肺癌组,差别有统计学意义（P＜0.01）.绘制ROC曲线,通过计算曲线下面积得知：取PI＞15.7 dB作为判断肺癌标准时灵敏度和特异度均较高（分别为66.7％,81.2％）；取EI＞10.77 dB作为判断肺癌标准时灵敏度和特异度均较高（分别为81.5％,68.8％）.结论 超声造影可提高对肺部病变内有血供组织和坏死组织的鉴别,有助于提高活检阳性率；造影参数PI和EI值有利于原发性肺癌和非肺癌之间的鉴别.Objective To evaluate the value of the differential diagnosis of peripheral pulmonary cancer using contrast-enhanced ultrasound （CEUS）.Methods Totally 59 patients selected with peripheral pulmonary lesions（27 primary lung cancer and 32 non-lung cancer cases including 12 pulmonary abscess,19 tuberculosis and 1 hemangioma subjects）were examined by traditional gray-scale sonography and color Doppler flow imaging （CDFI）,the lesions shape,borders,echo characteristic and blood flow were recorded first,and then the contrast enhanced sonographic studies were performed.The process of contrast enhancement and regression was observed and the parameters were quantitative analyzed by acoustic quantification analysis software （ACQ）.Finally,surgery or biopsy were conducted.Results CEUS had higher detection rates of blood flow signals than CDFI（ P 〈0.001 ）.There were significant differences （P 〈 0.01） between the primary lung cancer group and the non-lung cancer group regarding parameters peak intensity （ PI ） and enhanced intensity （ EI ）.By drawing the ROC curve and obtaining the area under the curve：a cut-off value〉15.7 dB of PI in assessing lung cancer had higher sensitivity and specificity （66.7 %,81.2%）.A cut-off value〉 10.77 dB of EI in assessing lung cancer had higher sensitivity and specificity （81.5%,68.8%）.Conclusions CEUS is helpful to identify necrotic tissue in biopsy and improving the biopsy positive rate.The parameters of PI and EI can help to identify the primary lung cancer with the Nonlung cancer.

关 键 词：超声检查 微气泡 肺肿瘤 诊断 鉴别 

分 类 号：R445.1[医药卫生—影像医学与核医学]