肺外周肿瘤超声造影与增强CT诊断的对比研究

Enhancement pattern of peripheral lung carcinoma： comparison between contrast-enhanced ultrasonography and contrast-enhanced computed tomography

目的探讨肺外周肿瘤对比增强超声造影（CEUS）与增强CT（CECT）的价值对比。方法对35例患者均经病理证实的肺外周肿瘤进行了CEUS和CECT检查的对照。CEUS采用造影剂六氟化诺（剂声诺维）和低机械指数实时超声成像技术。CECT采用造影剂碘普罗胺（商品名优维显），行平扫加增强扫描。结果35例患者超声造影增强后肺外周肿瘤表现为高增强20例（57．1％），低增强14例（40％），无增强1例（2．9％）；CECT表现为高增强15例（42．9％），低增强19例（54．3％），无增强1例（2．9％）；肿瘤CEUS表现为不均匀增强24例（68．6％），均匀增强10例（28．6％），1例无增强（2．9％）；CECT表现为不均匀增强26例（74．3％），均匀增强8例（22．9％），1例无增强（2．9％）；分析CEUS与CECT增强水平和增强程度存在的差异无统计学意义，肿瘤的CT增强值（HU）和B超增强值（dB）相关性较高。结论超声造影对肺外周肿瘤的诊断价值可与增强CT相当。

Objective To compare the enhancement pattern of low mechanicalindex contrastenhanced uhrasonography （CEUS） in peripheral lung carcinoma with contrast-enhanced helical CT （CECT）. Methods Thirty-five patients with peripheral lung carcinoma underwent CEUS performed with the contrast agent SonoVue at a low mechanical index contrast specific mode and CECT performed with the contrast agent Uhravist at a standard biphasic helical CT scaning protocol. The enhancement pattern related to tumor vascularity was analyzed. Results By using contrast-enhanced sonography, hyper-enhancement patterns were manifested in 57.1% （20/35） of the lesions and hypo-enhancement in 40% （14/35）; both not significantly different from those manifested by using CECT [ 42. 9% （ 15/35 ） and 54. 3% （ 19/35 ） of the lesions respectively, both P 〉 0. 05 ]. By using CEUS, inhomogenous enhancement pattern rate in the lesions was 68.6% （24/35） and the homogeneous enhancement rate was 28. 6% （10/35）, both not significantly different from those of the CECT group [ 74. 3% （26/35） and 22. 9% （8/35） respectively, both P 〉 0.05 ]. The non-enhancement rates of CEUS and CECT groupd were both 2. 9% （1/35）. The enhancement intensity dB value of the CEUS group was positively correlated with the CT value of the CECT tumors （ r = 0. 836, P 〈0. 001）. Conclusion The diagnotic value of contrast-enhanced sonography is similar to that of enhancement CT in detecting peripheral lung carcinoma＇s vascularity.