常规超声与超声造影引导下周围型肺肿块穿刺活检的对比研究  

Comparison of Contrast-enhanced Ultrasound and Conventional Ultrasound for Guiding Peripheral Pulmonary Biopsies

作　　者：毛枫 季正标 金赟杰 范培丽 王文平 Mao Feng;Ji Zhengbiao;Jin Yujie;Fan Peili;Wang Wenping(Department of Ultrasound,Zhongshang Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院超声科,上海市200032

出　　处：《中国超声医学杂志》2020年第8期691-694,共4页Chinese Journal of Ultrasound in Medicine

基　　金：上海市临床重点专科项目(No.shslczdzk03501);上海市卫生与计划生育委员会基金项目(No.201540077);上海市科学与技术委员会医学引导类项目(No.16411968400)。

摘　　要：目的探讨常规超声和超声造影在引导周围型肺肿块穿刺活检中的应用价值。方法回顾性分析了来我院就诊的252例周围型肺肿块的患者,共252个病灶行超声引导下肿块穿刺活检术。131例行常规超声检查引导,121例行超声造影检查引导。比较两组肿块内坏死区数目、大小、周围大血管显示率及穿刺正确率等情况。造影组同时观察肺肿块的增强时相及特征并分析。结果252例患者,共252个病灶,平均大小为(45.3±10.7)mm,良性病变82个,恶性病变150个。131例常规超声组中,71例恶性,43例良性;121例造影组中,79个恶性肿瘤,开始增强时间为(14.3±4.5)s、达峰时间为(24.9±6.9)s、减退时间为(44.3±17.7)s;39个良性肿瘤,开始增强时间为(11.6±3.7)s、达峰时间为(20.5±4.9)s、减退时间为(49.6±15.8)s,良恶性肿块在开始增强时间上差异有统计学意义(P<0.05),在达峰时间和减退时间上差异无统计学意义(P>0.05)。造影组穿刺后出现2例并发症;常规超声组有5例并发症。131例常规超声组有25个显示有坏死区,显示率为19.1%(25/131),坏死区平均大小为(15.3±10.7)mm;周围及内部大血管显示率为26.7%(35/131);121例造影组中有85个出现坏死区,坏死区显示率为70.2%(85/121),坏死区平均大小为(35.5±16.7)mm,周围及内部大血管显示率为42.1%(51/121)。造影组中在坏死区显示率、坏死区大小及周围血管显示方面高于常规超声组,两者间差异有统计学意义(P<0.05)。造影组穿刺正确率为97.5%(118/121),常规超声组为87.0%(114/131),造影组穿刺正确率明显高于非造影组,两组间差异具有统计学意义(P<0.05)。结论超声造影能准确显示周围型肺肿块内的坏死区及周围大血管,提高穿刺的正确率,具有较大的临床应用价值。Objective To compare conventional ultrasound and Contrast-enhanced ultrasound(CEUS)in the guidance of peripheral pulmonary biopsies.Methods The study was focused on 252 patients with a total of 252 peripheral pulmonary lesions from retrospectively.All the patients were divided two groups randomly.One is punctured by regular gray-scale and the other is by CEUS.The number and size of the necrotic area,the display rate of surrounding large vessels and the success rate of puncture were compared between the two groups.Meanwhile the enhancementphase and features of tumor was observed and analyzed in the CEUS group.Results There were a total of 252 peripheral lung masses with an average size of(45.3±10.7)mm,82 benign lesions and 150 malignant lesions.Of the 121 cases in the CEUS group,79 were malignant,with an initial enhancement of(14.3±4.5)s,a peak of(24.9±6.9)s and a decrease of(44.3±17.7)s.In 39 cases of benign tumors,the initial enhancement time was(11.6±3.7)s,the peak time was(20.5±4.9)s and the decrease time was(49.6±15.8)s.The difference between the two groups in the time of initial enhancement was statistically significant(P<0.05),while the difference in the time of peak arrival and the time of decrease was not statistically significant(P>0.05).There were 2 cases of complications after puncture in CEUS group.There were 5 cases of complications in routine ultrasound group.In the 131 routine ultrasound group,there were 25 cases showing necrotic area,with a display rate of 19.1%(25/131)and the average size of necrotic area was(15.3±10.7)mm.The display rate of peripheral and internal large vessels was 26.7%(35/131).There were 85 cases of necrosis in the 121 contrast groups,with the necrotic area showing 70.2%(85/121),the average size of necrotic area being(35.5±16.7)mm,and the peripheral and internal large vessels showing 42.1%(51/121).In contrast group,the display rate of necrotic area,size of necrotic area and peripheral blood vessels were higher than those in the conventional ultrasound group,and there

关 键 词：周围型肺肿块 穿刺活检 超声 超声造影 

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]