声脉冲辐射力弹性成像在周围型肺肿块中的诊断及研究  

Diagnosis and study of acoustic pulse radiation force elastography(ARFI)in peripheral pulmonary masses

作　　者：卢玉婵 韦虹[2] 王显翔 李响[1] 孙辉[2] 纪巧 LU Yu-chan;WEI Hong;WANG Xian-xiang;LI Xiang;SUN Hui;JI Qiao(Department of Ultrasonic,the Seventh Affiliated Hospital Sun Yat-sen University,Shenzhen,Guangdong 518107,China;Inpatient Ultrasound Department,the Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150086,China)

机构地区：[1]中山大学附属第七医院超声科,广东深圳518107 [2]哈尔滨医科大学附属第二医院住院处超声科,黑龙江哈尔滨150086

出　　处：《临床肺科杂志》2022年第12期1783-1787,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的针对肿块在超声造影中的增强区域,利用两种超声弹性成像技术,鉴别周围型肺肿块的良恶性,并评估其诊断效能。方法对100例肿块进行超声弹性成像检查,包括应变弹性成像(strain elastography,SE),声脉冲辐射力弹性成像(acoustic radiation force impulse,ARFI)技术。结果良恶性肿块的SE弹性评分比较,差异具有统计学意义(P=0.031),并且良恶性病灶的声触诊组织成像(acoustic palpation tissue imaging,VTI)和声触诊组织定量(virtual touch quantification,VTQ)之间的差异都具有统计学意义(P<0.001)。以3分作为鉴别良恶性肿块的截断点,发现SE的特异性为0.76,VTI的敏感性为0.84。关于观察者间一致性,SE评分4分恶性组一致性好,VTI评分4分良性组及恶性组一致性好。恶性病灶的剪切波速度大于良性病灶(2.46±0.89)m/s VS(1.79±0.89)m/s,(P<0.001),差异具有统计学意义。以1.944 m/s作为VTQ鉴别良恶性的截断点时,提示恶性病灶的敏感性、特异性、阳性预测值(positive predictive value,PPV)和阴性预测值(negative predictive value,NPV)分别为0.73、0.74、0.82、0.62。结论ARFI技术有助于鉴别周围型肺肿块的良恶性,具有一定的诊断效能。Objective To distinguish the benign and malignant of peripheral lung masses and to evaluate their diagnostic efficacy in the enhanced region of contrast-enhanced ultrasound by two types of ultrasound elastography.Methods 100 consecutive patients with one hundred peripheral lung masses were included.Strain elastography(SE)and acoustic radiation force impulse(ARFI)elastography were performed.Results The presence of bronchial air sign and insufficiency of blood flow were predictors of malignant lesions with lesion diameter greater than 5cm(P<0.05).The difference of SE elasticity score between benign and malignant tumors was statistically significant(P=0.031),and the difference of VTI and VTQ between benign and malignant lesions was statistically significant(P<0.001).Taking 3 points as the cutoff point for differentiating benign and malignant masses,the corresponding specificity of SE was 0.76,and the sensitivity of VTI was 0.84.As for the inter-observer consistency,the SE score of 4 was good in the malignant group,and the VTI score of 4 was good in the benign and malignant group.The shear wave velocity of malignant lesions was higher than that of benign lesions(2.46±0.89m/s VS 1.79±0.89m/s,P<0.001).While 1.944 m/s was used as the cut-off point for differentiating benign and malignant lesions,the sensitivity,specificity,PPV and NPV of malignant lesions were 0.73,0.74,0.82 and 0.62,respectively.Conclusion ARFI elastography is helpful in distinguishing malignant peripheral lung masses from benign ones,and it has certain diagnostic efficacy.

关 键 词：超声 周围型肺肿块 弹性成像技术 

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]