实时剪切波弹性成像联合超声造影对单发周围型肺肿块性质的鉴别诊断价值分析  

Value of real-time shear wave elastography combined with contrast-enhanced ultrasound in differential diagnosis of single peripheral pulmonary mass

作　　者：彭军 张军 屈静 周萌 梁军 周美兰 Peng Jun;Zhang Jun;Qu Jing;Zhou Meng;Liang Jun;Zhou Meilan(Department of Functional Examination,Wuhan Pulmonary Hospital,Wuhan 430000,China)

机构地区：[1]武汉市肺科医院功能检查科,武汉430000

出　　处：《肿瘤综合治疗电子杂志》2022年第3期114-119,共6页Journal of Multidisciplinary Cancer Management(Electronic Version)

摘　　要：目的探讨实时剪切波弹性成像(shear wave elastography,SWE)联合超声造影(contrast-enhanced ultrasound,CEUS)对单发周围型肺肿块性质的鉴别诊断价值。方法选取2017年1月至2022年1月武汉市肺科医院收治的98例单发周围型肺肿块患者为研究对象,根据病理结果将其分为良性组(39例,包括肺炎31例、肺结核5例、神经鞘瘤3例)、腺癌组(26例)与鳞癌组(33例)。比较三组患者的临床资料、实时SWE与CEUS检查相关参数,采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)的曲线下面积(area under the curve,AUC)评价各参数对肺肿块良恶性的诊断价值。结果三组患者的性别比例、年龄、肿块最大径比较差异均无统计学意义(均P>0.05)。良性组患者的实时SWE检查相关参数[最大弹性模量值(Emax)、最小弹性模量值(Emin)、平均弹性模量值(Emean)]与CEUS检查相关参数(始增时间、达峰时间、峰值强度)均显著低于腺癌组与鳞癌组(均P<0.05),鳞癌组的峰值强度显著低于腺癌组(P<0.05),而腺癌组与鳞癌组的Emax、Emin、Emean、始增时间、达峰时间比较差异均无统计学意义(均P>0.05)。ROC曲线表明,Emax、Emin、Emean、始增时间、达峰时间、峰值强度对肺肿块的良恶性均具有一定的预测价值(AUC为0.7~0.9),其中峰值强度的预测价值最高,其次是Emean,二者联合后的预测价值较高(AUC>0.9)。结论实时SWE与CEUS均能有效鉴别单发周围型肺肿块的良恶性,二者联合后能进一步提高诊断价值,且CEUS在鉴别腺癌与鳞癌方面也可能有一定帮助。Objective To investigate the value of real-time shear wave elastography(SWE)combined with contrastenhanced ultrasound(CEUS)in differential diagnosis of single peripheral pulmonary mass.Method Ninety-eight patients with single peripheral pulmonary mass treated in Wuhan Pulmonary Hospital from January 2017 to January 2022 were enrolled for the research and divided into benign group(39 cases,including 31 cases of pneumonia,5 cases of pulmonary tuberculosis and 3 cases of neurilemmoma),adenocarcinoma group(26 cases)and squamous carcinoma group(33 cases)according to the pathological results.The clinical data,real-time SWE and CEUS examination related parameters were compared among the three groups.The area under the curve(AUC)of receiver operating characteristic curve(ROC curve)was performed to evaluate the diagnostic value of each parameter for benign and malignant pulmonary mass.Result There were no significant differences in gender,age and maximum diameter of mass among the three groups(all P>0.05).The related parameters of real-time SWE examination[maximum elastic modulus(Emax),minimum elastic modulus(Emin),average elastic modulus(Emean)]and CEUS examination(initial increase time,peak time,peak intensity)in benign group were significantly lower than those in adenocarcinoma group and squamous carcinoma group(all P<0.05),and the peak intensity in squamous carcinoma group was significantly lower than that in adenocarcinoma group(P<0.05).There were no significant differences in Emax,Emin,Emean,initial increase time and peak time between adenocarcinoma group and squamous carcinoma group(all P>0.05).The results of ROC curve showed that Emax,Emin,Emean,initial increase time,peak time and peak intensity had certain prediction value for benign and malignant pulmonary mass(AUC was 0.7 to 0.9),among which the prediction value of peak intensity was the highest,followed by Emean,and the prediction value after the combination of two parameters was higher(AUC>0.9).Conclusion Real-time SWE and CEUS can effectively distinguish the

关 键 词：实时剪切波弹性成像 超声造影 周围型肺肿块 鉴别诊断 

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]