超声增强造影引导穿刺活检在胸膜病变及肺周围型肿块中的应用  

Application of Contrast-enhanced Ultrasound Guided Biopsy in Pleural Lesions and Peripheral Pulmonary Masses

作　　者：王丹郁 钟丽兰[1] 涂滨[1] 刘照宏[1] 梁彤[1] Wang Danyu;Zhong Lilan;Tu Bin;Liu Zhaohong;Liang Tong(Department of Ultrasound,Foshan Hospital of Traditional Chinese Medicine,Foshan,Guangdong 528000)

机构地区：[1]佛山市中医院超声科,广东佛山528000

出　　处：《现代医用影像学》2021年第7期1228-1232,共5页Modern Medical Imageology

基　　金：佛山市医学类科技攻关项目(2017AB002601)。

摘　　要：目的:探讨胸膜病变及肺周围型肿块在超声增强造影引导下穿刺活检的应用价值。方法:对80例已行CT检查提示胸膜病变或肺周围型肿块患者进行分组,分常规超声引导穿刺组(对照组)和超声增强造影引导穿刺组(造影组),分析对照组和造影组穿刺的阳性率以及造影组内造影增强不同区域的穿刺阳性率,评估超声增强造影引导胸部病变穿刺活检的价值。结果:80例患者,恶性肿瘤47例,包括肺腺癌25例,肺鳞癌11例,肺转移癌3例,神经内分泌癌4例,恶性间皮瘤2例,肉瘤样癌2例;良性的病变为24例,包括炎性病灶10例,结核13例,软骨性错构瘤1例;无法诊断者9例。造影组引导的穿刺阳性率高于对照组(P<0.05),超声造影能够区分病灶的增强区和不增强区,造影组内在增强区的穿刺阳性率高于不增强区(P<0.01)。结论:超声增强造影引导胸膜病变及肺周围型肿块穿刺活检是一种创伤少、精准、安全的方法,能够有效指引操作者避开病灶内坏死组织,从而提高超声引导穿刺活检的阳性率,具有很好的临床应用价值。Objective:To investigate the application value of pleural lesions and peripheral pulmonary masses guided by contrast-enhanced ultrasound(CEUS).Methods:80 patients with pleural lesions or peripheral pulmonary parenchymal lesions found by CT examination were divided into conventional ultrasound-guided puncture group(control group)and contrast-enhanced ultrasound-guided puncture group(contrast group).The positive rate of puncture in the control group and contrast-enhanced group and the puncture positive rate in different areas of contrast-enhanced contrast-enhanced group were analyzed,and the value of ultrasound-guided puncture biopsy was evaluated.Results:Among the 80 patients,47 cases had malignant tumors,including 25 cases of adenocarcinoma,11 cases of squamous cell carcinoma,3 cases of metastatic carcinoma,4 cases of neuroendocrine carcinoma,2 cases of malignant mesothelioma,2 cases of sarcomatoid carcinoma;24 cases of benign lesions,including 10 cases of inflammatory lesions,13 cases of tuberculosis,1 case of chondrohamartoma;9 cases of non diagnosis.The positive rate of puncture guided by contrast-enhanced ultrasound group was higher than that of control group(P<0.05).Contrast enhanced ultrasound could distinguish the enhanced area from the non enhanced area.The positive rate of puncture in the enhanced area was higher than that in the non enhanced area(P<0.01).Conclusion:CEUS guided puncture biopsy is a minimally invasive,rapid and safe method,which can guide the puncture personnel to avoid the necrotic area in the lesion,thus effectively improving the positive rate of puncture biopsy,which plays an important role in the diagnosis of pleural and peripheral lung lesions.

关 键 词：超声增强造影 胸膜病变 周围型肺肿块 超声引导 介入治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]