超声对肺恶性肿瘤的诊断应用

Application of ultrasonography for the diagnosis of pulmonary malignancy

目的：探讨超声对肺恶性肿瘤的诊断应用价值。资料与方法：外周型肿瘤81例为A组，中心型肺肿瘤71例为B组，无气肺内弥漫型多发肿瘤28例为C组，分别讨论了不同类型肺恶性肿瘤的声像图表现。结果：A组中腺癌多见，占44％，弱回声占65％，肿瘤表面脏胸膜异常占79％，胸膜中断内收可呈“兔耳”征及“V”字形结构，有助于肺癌的检出。B组以鳞癌多见，占39％，声像图可分为三型，其中结节型占51％，肿块型占41％，气管内型占8％。C组28例中，以小细胞肺癌及鳞癌、肺癌的肺内转移多见，43％肿瘤呈给节融合状或葡萄状，57％呈小结节散在分布；对比三种影像诊断方法对C组肿瘤的检出率，可见X线平片为20％，CT为38％，超声为82％，纤维支气管镜检出主病灶为88％。14例超声首诊发现的肿瘤，主要为C组病例及肺外周型小于2cm的转移癌。结论：对X线、CT发现肺周占位、肺内可疑占位或肺不张的病例，行超声检查，有助于提高肺恶性肿瘤的诊断率，值得推广应用。

Objective: In the present paper ultrasonographic findings of Pulmonary carcinoma in different location were summarized andanalyzed to evaluate the application of ultrasound to the diagnosis of pulmonary malignancy.Materials and Methods: Group A consisted of81 cases of peripheral type, group B 71 cases of central type and proup C 28 cases of multiple diffuse type in apneumatic lung.The ultrasonographic pictures of various types of lung malignany were discussed separately. Results: Adenocarcinoma was mostly seen in proup Aamounting to 44% with hypoecho predominating(65% ) and with abnormal visceral pleaura overlying the tumor frequently seen(79% )Interruption and adduction of pleure gave rise to a positive 'rabbit ear' sign and 'V' shaped configuration. Squamous cell carcinomawas frequently seen in group B amounting to 39%. Its ultrasonogram showed the following 3 types: nodular type (51%), tumor type (41% )and intra-bronchial type(8% ). Among the 28 cases in group C intrapulmonary spreading of small cell lung careinoma and squamous carcinoma were frequently seen. Coalluent nodular and grape-like tumors amounted to 43%. Small nodules with scattered distribution amounted to57% .Contrasting the three diagnostic methods for imaging the detecting rates for group C were 20% in X-ray plain film, 38% in CT and82% in ultrasound.The detecting rate of principal focus by fiber bronchoscopy was 88%. Conclusion: For peripheral space-occupying lesion, suspicious intrapulmonary space-occupying lesion and atelectasis detected by X-ray、CT、Ultrasonography helps raising the diagnosticrate of pulmonary malignancy, worthy of spreading.