超声造影在肺周围型病灶穿刺活检中的应用

Application of contrast-enhanced ultrasound guidance in puncture biopsy of peri-pulmonary lesions

目的探讨超声造影在肺周围型病灶穿刺活检中的应用。方法回顾性分析武警特色医学中心超声科2019-01至2020-12在超声引导下穿刺的肺周围型病灶活检117例患者的相关资料。按操作方法分为,造影组(超声造影引导穿刺)52例和对照组(常规超声引导穿刺)65例。造影组常规超声检查后行超声造影检查,观察造影剂的灌注及病灶增强情况,针对病灶明显增强区域行穿刺活检。对照组在常规超声引导下对实性区域穿刺活检。获取穿刺病理结果,以手术病理作为最终诊断结果,分析比较造影组与对照组穿刺阳性率、并发症以及病灶坏死区域的显示率。结果造影组穿刺阳性率为96.15%(50/52),明显高于对照组的84.62%(55/65),两组差异有统计学意义(P<0.05)。对直径>50 mm的病灶,造影组穿刺阳性率高于对照组(95.45%vs.70.83%),差异有统计学意义(P<0.05)。结论超声造影引导穿刺活检的成功率高于常规超声引导穿刺,特别是对于病灶直径>50 mm,建议首选超声造影引导穿刺。

Objective To probe the application of contrast-enhanced ultrasound(CEUS)guidance in puncture biopsy of peri-pulmonary lesions.Methods One hundred and seventeen cases of ultrasound-guided peri-pulmonary lesion biopsy from January 2019 to December 2020 in our hospital were divided into experimental group(contrast-enhanced ultrasound guided puncture,n=52)and control group(conventional ultrasound-guided puncture,n=65).After the experimental group underwent CEUS examination the perfusion of contrast agent and the enhancement of the lesions were observed,and puncture biopsy for the significantly enhanced area of the lesions was performed.In the control group,conventional ultrasound was used to guide the puncture biopsy of the solid area.The puncture pathology results were obtained,and the surgical pathology were used as the final diagnosis.Statistical analysis was performed to compare the puncture success rate,positive puncture rate,complications,and necrotic area rate.Results The positive puncture rate in the experimental group was statistically higher than that in the control group(96.15%vs.84.62%)(P<0.05).For lesions with diameters larger than 50 mm,the positive puncture rate was also significantly higher in the experimental group than in the control group(95.45%vs.70.83%)(P<0.05).Conclusions The efficacy of CEUS guided punch biopsy was higher than conventional ultrasound-guided guided punch biopsy.For the lesions larger than 50 mm,CEUS guided puncture biopsy was strongly recommended.