超声造影VueBox定量参数对外周型肺肿块良恶性鉴别诊断价值  

Value of contrast-enhanced ultrasound quantitative parameters by VueBox software to the differential diagnosis of benign and malignant peripheral lung masses

作　　者：许金枝 姜珏[1] 何鑫[1] 周琦[1] 梁汝娜 杨元兴 周茹 王娟[1] XU Jin-zhi;JIANG Jue;HE Xin;ZHOU Qi;LIANG Ru-na;YANG Yuan-xing;ZHOU Ru;WANG Juan(Department of Ultrasound,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanci 710004,China)

机构地区：[1]西安交通大学第二附属医院医用超声研究室,陕西西安710004

出　　处：《中华实用诊断与治疗杂志》2023年第5期513-517,共5页Journal of Chinese Practical Diagnosis and Therapy

基　　金：陕西省重点研发计划项目(2023-YBSF-392)。

摘　　要：目的 分析外周型肺肿块患者超声造影VueBox定量参数变化,探讨其对外周型肺肿块良恶性质的鉴别诊断价值。方法 外周型肺肿块患者57例,均行常规超声、超声造影、超声引导下组织穿刺活检,并根据活检组织病理检查结果分为恶性肿瘤组44例和炎性病变组13例。应用VueBox软件定量分析2组超声造影声像,记录峰值强度(peak enhancement,PE)、流入相曲线下面积(wash-in area under the curve, WiAUC)、流入相灌注指数(wash-in perfusion index,WiPI)、流出相比率(wash-out rate,WoR)等血流参数。比较2组性别比例、年龄、肿块直径、形态、超声造影灌注特征及超声造影VueBox血流参数;绘制ROC曲线,评估超声造影VueBox血流参数诊断恶性外周型肺肿块的效能。结果 (1)恶性肿瘤组肿块直径[(5.47±2.60)cm]大于炎性病变组[(3.77±1.67)cm](t=-2.801,P=0.009),肿块形态不规则(56.82%)、造影剂灌注特征呈向心型(68.18%)比率均高于炎性病变组(23.07%、30.77%)(χ^(2)=10.347,P=0.004;χ^(2)=9.965,P=0.009),有支气管征比率(25.00%)低于炎性病变组(69.23%)(χ^(2)=6.787,P=0.009);2组性别比例、年龄及肿块位置、血流模式、造影剂分布特征比较差异均无统计学意义(P>0.05)。(2)恶性肿瘤组PE[17 747.75(8 489.65,26 402.78)a.u]、WiAUC[92 865.91(63 717.03,174 225.63)a.u]、WiPI [11 449.48(5 723.01,16 960.49)a.u]、WoR [1 035.87(512.28,1 569.70)a.u]均大于炎性病变组[9 551.68(6 164.52,15 604.92)、56 670.20(43 150.16,83 626.39)、6 420.37(4 151.84,9 808.46)、485.27(211.42,1 072.89)a.u](P<0.05),上升时间、局部平均渡越时间、达峰时间、流入相比率、流出相曲线下面积、灌注-廓清曲线下面积、廓清时间、感兴趣区面积与炎性病变组比较差异均无统计学意义(P>0.05)。(3)PE、WiAUC、WiPI、WoR分别以19 912.56、94 569.57、10 872.33、576.59 a.u为最佳截断值,诊断恶性外周型肺肿块的AUC分别为0.712(95%CI:0.576~0.824,P=0.003)、0.726(95%CI:0.591Objective To analyze the quantitative parameters of contrast-enhanced ultrasound(CEUS)of peripheral pulmonary masses by using VueBox software,and to investigate their values to the differential diagnosis of benign and malignant peripheral pulmonary masses.Methods Fifty-seven patients with peripheral lung masses underwent conventional ultrasound,CEUS and ultrasound-guided biopsy,and were divided into malignancy group(n=44)and inflammatory lesion group(n=13)according to the histopathological results.The CEUS images were quantitatively analyzed by VueBox software to record the peak enhancement(PE),wash-in area under the curve(WiAUC),wash-in perfusion index(WiPI),wash-out rate(WoR)and other blood flow parameters.The gender ratio,age,mass diameter,morphology,CEUS perfusion characteristics and blood flow parameters were compared between two groups.ROC curves were drawn to evaluate the efficiencies of CEUS perfusion parameters on the differential diagnosis of benign and malignant peripheral lung masses.Results(1)The mass diameter was longer in malignancy group[(5.47±2.60)cm]than that in inflammatory lesion group[(3.77±1.67)cm](t=-2.801,P=0.009).The incidences of irregular shape and centripetal perfusion were higher in malignancy group(56.82%,68.18%)than those in inflammatory lesion group(23.07%,30.77%)(χ^(2)=10.347,P=0.004;χ^(2)=9.965,P=0.009),and the percentage of bronchial signs was lower in malignancy group(25.00%)than that in inflammatory lesion group(69.23%)(χ^(2)=6.787,P=0.009).There were no significant differences in the gender ratio,age,mass location,blood flow pattern and distribution of contrast agent between two groups(P>0.05).(2)The PE,WiAUC,WiPI and WoR were greater in malignancy group[17747.75(8489.65,26402.78),92865.91(63717.03,174225.63),11449.48(5723.01,16960.49),1035.87(512.28,1569.70)a.u]than those in inflammatory lesion group[9551.68(6164.52,15604.92),56670.20(43150.16,83626.39),6420.37(4151.84,9808.46),485.27(211.42,1072.89)a.u](P<0.05),and there were no significant differences in the rise time

关 键 词：外周型肺肿块 常规超声 超声造影 VueBox定量参数 

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]