肺周边局灶性炎症超声声像图特征分析

Analysis of Sonographic Characteristics of Peripheral Focal Inflammation of Lung

目的探讨肺周边局灶性炎症的声像图特征,提高超声对肺周边局灶性病变的诊断与鉴别诊断能力。方法回顾性分析44例肺周边局灶性炎症患者的声像图,与其他病变声像图特征进行对比,将病灶边界清晰度、回声类型、脏胸膜继发改变、病灶内表面成角、病灶内支气管气相作为自变量,病灶性质是否为周边局灶性炎症作为因变量进行Logistic分析。病理结果经超声引导穿刺活检获得。结果病灶内表面成角和病灶内支气管气相对诊断肺周边局灶性炎症有显著影响(P<0.01)。以病灶内表面成锐角作为诊断肺周边局灶性炎症的标准,与穿刺活检结果对比,超声检查对肺周边局灶性炎症诊断的准确率为82.6%,敏感度为72.7%,特异度为84.7%,阳性预测值为51.0%,阴性预测值为93.4%。结论病灶内表面成锐角及病灶内支气管气相对诊断肺周边局灶性炎症有一定价值。床旁超声可以诊断肺周边局灶性炎症。

Objective To evaluate the sonographic characteristics of peripheral focal inflammation of lung, and to improve the diagnosis and differential diagnosis potency of sonography for pulmonary peripheral lesions. Methods The sonogram of 44 patients with peripheral focal inflammation of lung were retrospectively analyzed and compared with the sonogram of other lesions. Independent variables included lesion＇ s margin, echotype, the secondary change of visceral pleura, the angnlation of lesion＇ s inner surface and air bronchogram. Lesion＇ s nature was as dependent variable. The data was analyzed by Logistic regression analysis. Pathological results were confirmed by biopsy. Results The angulation of lesion＇ s inner surface and air bronchogram were significant factors affecting the diagnosis of peripheral focal inflammation of lung（P 〈0. 01）. Compared to the pathological yield by biopsy,angulation of lesion＇ s inner surface being acute angle for diagnosis of peripheral focal inflammation of lung had an accuracy rate of 82. 6% ,a sensitivity of 72. 7% ,a specificity of 84. 7% ,a positive predictive value of 51.0% ,and a negative predictive value of 93.4%. Conclusions The acute angle of lesion＇ s inner surface and air bronchogram are sonographic characteristics of peripheral focal inflammation of lung. Bedside lung ultrasound is useful to the diagnosis of peripheral focal inflammation of lung.