超声造影与高分辨率CT对周围型肺肿物的鉴别诊断价值  

Value of contrast-enhanced ultrasound and high resolution CT in differential diagnosis of peripheral pulmonary masses

作　　者：于艳艳[1] Yu Yanyan(Department of Ultrasound Medicine,Huaihe Hospital of Henan University,Kaifeng 471000,China)

机构地区：[1]河南大学淮河医院超声医学科,开封471000

出　　处：《中国实用医刊》2024年第6期76-79,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析超声造影(CEUS)与高分辨率CT(HRCT)对周围型肺肿物的鉴别诊断价值。方法描述性研究。抽取2021年2月至2022年1月河南大学淮河医院收治的周围型肺肿物患者98例,均接受CEUS、HRCT及病理检查,以病理检查为"金标准",统计CEUS与HRCT对周围型肺肿物的诊断结果和诊断效能,分析良恶性周围型肺肿物患者的CEUS定量参数与HRCT特征。结果98例周围型肺肿物患者中,经病理检查确诊恶性52例,良性46例;CEUS诊断出恶性43例,良性40例;HRCT诊断出恶性51例,良性31例。CEUS的诊断灵敏度为82.69%(43/52),误诊率为13.04%(6/46),低于HRCT诊断的98.08%(51/52)、32.61%(15/46);CEUS的诊断特异度为86.96%(40/46),漏诊率为17.31%(9/52),高于HRCT诊断的67.39%(31/46)、1.92%(1/52),P<0.05。CEUS检查结果显示,恶性患者造影剂多呈不均匀分布(75.00%,39/52),增强模式多为慢进快出(75.00%,39/52),增强强度多为高增强(73.08%,38/52);良性患者造影剂多呈均匀分布(52.17%,24/46),增强模式多为快进快出(78.26%,36/46),增强强度多为等增强(45.65%,21/46)。HRCT检查结果显示,恶性患者毛刺征、空泡征、分叶征检出率分别为59.62%(31/52)、38.46%(20/52)、53.85%(28/52),高于良性患者的17.39%(8/46)、10.87%(5/46)、23.91%(11/46),P<0.05。结论CEUS与HRCT用于周围型肺肿物良恶性鉴别诊断中具有一定价值,CEUS特异度较高,HRCT灵敏度较高,临床可将二者结合以提升诊断准确性。Objective To analyze the value of contrast-enhanced ultrasound(CEUS)and high resolution computed tomography(HRCT)in differential diagnosis of peripheral pulmonary masses.Methods A total of 98 patients with peripheral pulmonary masses treated in Huaihe Hospital of Henan University from February 2021 to January 2022 were selected for the descripitive study.All patients underwent CEUS,HRCT and pathological examinations.Taking results of pathological examination as the gold standard,the diagnostic results and diagnostic efficacy of CEUS and HRCT in the diagnosis of peripheral pulmonary masses were counted.The CEUS quantitative parameters and HRCT characteristics of benign and malignant peripheral pulmonary masses were analyzed.Results Among the 98 patients with peripheral pulmonary masses,52 cases were diagnosed as malignant by pathological examination,and 46 cases were identified as benign;43 cases were identified as malignant by CEUS,and 40 cases were identified as benign;51 cases were identified as malignant by HRCT,and 31 cases were identified as benign.The sensitivity and misdiagnosis rate of CEUS(82.69%,43/52;13.04%,6/46)were lower than those of HRCT(98.08%,51/52;32.61%,15/46),P<0.05;and the specificity and missed diagnosis rate of CEUS(86.96%,40/46;17.31%,9/52)were higher than those of HRCT(67.39%,31/46;1.92%,1/52),P<0.05.The results of CEUS showed that the contrast agent in malignant patients was unevenly distributed(75.00%,39/52),the enhancement pattern was mostly slow-in-fast-out(75.00%,39/52),and the enhancement intensity was mostly high(73.08%,38/52).The contrast agent in benign patients was uniformly distributed(52.17%,24/46),the enhancement pattern was mostly fast-in-fast-out(78.26%,36/46),and the enhance intensity was mostly equal(45.65%,21/46).The results of HRCT examination showed that the detection rates of spiculation sign,vacuole sign and lobulation sign in malignant patients were 59.62%(31/52),38.46%(20/52)and 53.85%(28/52),respectively,which were correspondingly higher than the 17.39%(8/46),10.8

关 键 词：超声造影 高分辨CT 周围型肺肿物 诊断效能 

分 类 号：R734.2[医药卫生—肿瘤] R445.1[医药卫生—临床医学] R730.44