超声造影对肺周非肿瘤性病变的诊断应用价值  

The Value and Application of Contrast-enhanced Ultrasonography in the Diagnosis of Non-neoplastic Peripheral Lung Lesions

作　　者：王雪[1] 刘月洁[1] 暴婧[2] 李玉茜[2] 张万蕾[1] 李建国[1] 朱家安[1] Wang Xue;Liu Yuejie;Bao Jing;Li Yuqian;Zhang Wanlei;Li Jianguo;Zhu Jia′an(Department of Ultrasound,Peking University People′s Hospital,Beijing 100044,China;Department of Respiratory and Critical Care Medicine,Beking University People′s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院超声科,北京市100044 [2]北京大学人民医院呼吸与危重症医学科,北京市100044

出　　处：《中国超声医学杂志》2020年第4期328-331,共4页Chinese Journal of Ultrasound in Medicine

基　　金：北京大学人民医院科学与研究发展基金(院内基金)(No.RDY2017-29)。

摘　　要：目的探讨肺周非肿瘤性病变超声造影的特征,以期提高超声造影在肺周疾病识别和临床应用价值。方法对于我院因近胸膜处肺周非肿瘤性病变为诊断的住院患者,根据病程分为急性疾病组和慢性疾病组,分别常规超声观察记录病灶大小、形态、回声及血流特征,超声造影观察肺、病灶及胸膜开始增强时间(arrival time,AT)、病灶强化模式、病灶强化程度、强化均匀程度及消退程度,并收集有关临床资料进行分析。结果共纳入24例患者,平均年龄(64.6±9.7)岁,其中男性17例(占71%)。急性疾病组中,肺炎8例,超声造影开始增强时间早,多呈树枝状离心强化;肺脓肿4例,因病程不同而超声造影表现为高增强伴不同程度液化区。慢性疾病组中,3例间质性肺炎和2例机化性肺炎均表现不均匀低增强;肺结核7例,超声造影表现多样。慢性疾病组AT(10.00±4.09)s及胸膜AT(13.80±4.24)s明显长于急性疾病组。所有病例均经超声引导下穿刺活检病理证实。结论超声造影是一种方便可行的辅助诊断肺周非肿瘤性病变的方法,超声造影引导穿刺活检可行、安全、高效。Objective To explore the characteristics of contrast-enhanced ultrasonography(CEUS) in non-neoplastic peripheral lung lesions in order to improve the recognition and clinical application value of CEUS. Methods Inpatients diagnosed with pleural and peripulmonary non-neoplasia were divided into acute disease group and chronic disease group according to the course of disease. The size, shape, echo and blood flow characteristics of lesions were recorded by conventional ultrasound observation. The arrival time(AT), pattern of focal enhancement, degree of focal enhancement, uniformity and resolution of focal enhancement were observed by contrast-enhanced ultrasound, and relevant clinical data were collected for analysis. Results A total of 24 patients were included, with an average age of(64.6±9.7) years, including 17 males(71%). In the acute disease group, there were 8 cases of pneumonia, and the contrast-enhanced ultrasound started early, and most of them presented dendritic centrifugal enhancement. Four cases of pulmonary abscess showed high enhancement with different degrees of liquefaction due to different course of disease. In the chronic disease group, 3 cases of interstitial pneumonia and 2 cases of institutionalized pneumonia showed uneven and low enhancement. There were 7 cases of pulmonary tuberculosis with various contrast-enhanced ultrasonography. Chronic disease group AT(10.00±4.09)s and pleural AT(13.80±4.24)s were significantly longer than acute disease group. All cases were confirmed by ultrasound-guided biopsy. Conclusions CEUS is a practical and effective method for the diagnosis and guiding puncture biopsy of peripulmonary inflammatory lesions.

关 键 词：超声造影 胸膜旁 肺周边病变 

分 类 号：R445.1[医药卫生—影像医学与核医学] R563[医药卫生—诊断学]