超声造影联合声辐射力脉冲成像在周围型肺占位中的临床应用价值研究  

Clinical application value of contrast-enhanced ultrasound combined with acoustic radiation pulse imaging in peripheral lung masses

作　　者：韦虹[1] 王曌曦 王一淳 周显礼[1] WEI Hong;WANG Zhaoxi;WANG Yichun;ZHOU Xianli(Department of Ultrasound,The Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China;Department of Medical Imaging,The Fourth Affiliated Hospital of Harbin Medical University)

机构地区：[1]哈尔滨医科大学附属第二医院住院处超声科,哈尔滨150086 [2]哈尔滨医科大学附属第四医院医学影像科

出　　处：《实用肿瘤学杂志》2023年第3期236-242,共7页Practical Oncology Journal

摘　　要：目的探讨超声造影(Contrast enhanced ultrasonography,CEUS)联合声辐射力脉冲成像(Acoustic radiation force impulse,ARFI)诊断周围型肺占位的临床应用价值。方法回顾性研究2019年1月—2021年6月在哈尔滨医科大学附属第二医院接受手术或活检病理确诊的51例周围型肺部病变患者,分析他们在常规超声、CEUS和ARFI检查中病灶的相关数据,评估并比较CEUS、ARFI及两者联合应用鉴别良恶性占位的诊断效能。结果肿块是否为类圆形在常规超声下良恶性组间有统计学差异(P<0.01)。恶性占位在CEUS中的始增时间(Rise time,RT)比良性占位RT更长且达峰时间(Time to peak,TTP)更短(P<0.05)。在ARFI检查中恶性占位的剪切波速度(Shear wave velocity,SWV)明显高于良性占位(P=0.04)。CEUS中占位RT和TTP分别超过10.5 s及19.5 s时诊断为恶性的敏感度为77.4%,特异度为85.0%,准确性72.5%。ARFI检查中占位SWV均值超过2.02 m/s诊断为恶性的敏感度为83.9%,特异度为50.0%,准确性70.6%。CEUS与ARFI至少满足其中之一时判断恶性占位的敏感度为96.8%,特异度为40.0%,准确性为74.5%。结论CEUS联合ARFI对周围型良恶性肺占位的诊断更敏感,准确性更高,可有效降低漏诊率。Objective The aim of this study was to investigate the clinical value of contrast enhanced ultrasonography(CEUS)combined with acoustic radiation force impulse(ARFI)in the diagnosis of peripheral pulmonary masses.Methods A total of 51 peripheral lung diseases patients who were confirmed by surgical or biopsy pathology in the Second Affiliated Hospital of Harbin Medical University from January 2019 to June 2021 were retrospectively studied,and their focus related data in routine ultrasound,CEUS and ARFI examinations were analyzed.The diagnostic performance of CEUS,ARFI,and their combination in differentiating benign and malignant masses was evaluated and compared.Results There was a significant difference between benign and malignant groups in whether the tumor was round or not under conventional ultrasound(P<0.01).The rise time(RT)of malignant tumors in CEUS was longer than and the time to peak(TTP)was shorter than that of benign lesions(P<0.05).In ARFI examination,the shear wave velocity(SWV)of malignant masses was significantly higher than that of benign masses(P=0.04).The sensitivity,specificity,and accuracy of diagnosing malignancy in CEUS were 77.4%,85.0%,and 72.5%,respectively,when the occupied RT and TTP exceeded 10.5s and 19.5s,respectively.The sensitivity,specificity and accuracy of diagnosing malignancy in ARFI examination were 83.9%,50.0%and 70.6%,respectively,with a mean SWV>2.02 m/s.CEUS and ARFI met at least one of the criteria,with a sensitivity of 96.8%,a specificity of 40.0%,and an accuracy of 74.5%to determine malignant lesions.Conclusion CEUS combined with ARFI is more sensitive and accurate in the diagnosis of peripheral benign and malignant lung masses,and can effectively reduce the rate of missed diagnosis.

关 键 词：肺癌 周围型肺占位 超声造影 声辐射力脉冲成像 

分 类 号：R73.4[医药卫生—肿瘤]