超声支气管镜弹性成像与气道周围病变良恶性相关性研究  

Study on the correlation between ultrasound bronchoscopy elastography and benign and malignant lesions around the airway

作　　者：陈俊男 陈中书[1] 冯剑雄[1] 施天生[1] 徐志宏 史红[2] CHEN Junnan;CHEN Zhongshu;FENG Jianxiong(Jiangxi Chest Hospital,Nanchang,330006,China)

机构地区：[1]江西省胸科医院,南昌330006 [2]江西省南昌市第一医院,南昌330006

出　　处：《江西医药》2020年第12期1756-1761,共6页Jiangxi Medical Journal

基　　金：江西省卫生计生委科技计划项目,编号20195592。

摘　　要：目的使用超声支气管镜(EBUS)探究实时超声弹性成像和气道周围病变之间的相关程度,进一步探讨超声支气管镜实时超声弹性成像在判断气道周围病变良恶性中的诊断价值。方法选择2018年6月-2019年6月期间在江西省胸科医院就诊的气道周围病变有淋巴结肿大的患者进行超声支气管镜(EBUS)支气管内超声检查,使用弹性成像的手法,将研究对象检查之后的良恶性病变部位的超声弹性成像相应特征、弹性成像和普通超声影像学特点进行对比分析,对这两种方法的精准程度进行研究,从而研究这一方法在判断气道周围病变良恶性情况的临床使用价值。结果本次研究对象共有40例病人,共有63例淋巴结行超声弹性成像进行测定,用病理组织学作为评判的金标准。在恶性病变中,运用该方法诊断的淋巴结阳性的有35枚、阴性的有4枚;在良性病变中,运用该方法诊断的淋巴结阳性的有6枚、阴性的有18枚。不同超声弹性成像分型组间良恶性构成比采用Fisher精确卡方(χ^2)检验比较,超声弹性成像分型在区分良恶性淋巴结的中具有显著的统计学意义(χ^2=33.600,P<0.05)。超声弹性成像对恶性淋巴结的敏感度、特异度、准确度分别为85.37%(35/41)、81.82%(18/22)、84.13%(53/63)。结论超声支气管镜弹性成像技术具有很高的敏感度、特异度以及准确度,能够帮助诊断气道周围病变良恶性特征,并且具有精确引导靶向穿刺的效果,在临床中使用有很好的效果。Objective Ultrasound bronchoscopy(EBUS)was used to investigate the correlation between real-time ultrasound elastography and peripheral airway lesions,and to further explore the diagnostic value of real-time ultrasound elastography with ultrasound bronchoscope in judging the benign and malignant lesions of the airway.Methods Retrospective analysis on June,2018 to June,2019 in Jiangxi province chest hospital around the airway lesions in patients with lymph node enlargement of endobronchial ultrasound(EBUS)ultrasonic bronchoscopy,elasticity imaging,all the patients after checking the benign and malignant lesions of the location of the ultrasound elasticity imaging characteristics,imaging and ordinary ultrasonic imaging characteristics,this paper compares and analyzes the precision degree of the two methods were studied,thus research around this method in judging the airway lesions of benign and malignant cases clinical use value.Results In this study,a total of 63 lymph nodes of 40 patients were examined by ultrasound elastography,and histopathology was used as the gold standard.In malignant lesions,35 and 4 positive and negative lymph nodes were identified by this method.In benign lesions,there were 6 positive and 18 negative lymph nodes.Fisher's accurate chi-square(χ^2)test was used to compare the proportion of benign and malignant lymph nodes in different ultrasound elastography classification groups,and there was a significant statistical difference in the selection of benign and malignant lymph nodes(χ^2=33.600,P<0.05).The sensitivity,specificity and accuracy of ultrasound elastography to malignant lymph nodes can be achieved:85.37%(35/41),81.82%(18/22)and 84.13%(53/63).Conclusion Ultrasound bronchoscope elastography technology has high sensitivity,specificity and accuracy,can help to diagnose the benign and malignant characteristics of the lesions around the airway,and has the effect of precise guided targeted puncture,it has a good effect in clinical use.

关 键 词：超声支气管镜 超声弹性成像 气道周围病变 良恶性淋巴结 

分 类 号：R445.1[医药卫生—影像医学与核医学]