超声造影鉴别诊断周围型肺局灶性病变的临床价值

Clinical value of contrast-enhanced ultrasound in the differential diagnosis of peripheral pulmonary focal lesions

目的探讨超声造影鉴别诊断周围型肺局灶性病变良恶性的临床价值。方法选取我院经活检病理或临床确诊的116个周围型肺局灶性病变,其中良性病灶62个,恶性病灶54个,比较良恶性病灶超声造影的增强时相和造影模式。结果良性病灶增强时相以早期增强为主(82.3%),恶性病灶以晚期增强为主(64.8%),二者比较差异有统计学意义(P<0.05)。良、恶性病灶造影模式比较差异有统计学意义(P<0.05),其中呈点片样增强的恶性病灶多于良性病灶(37个vs.23个),差异有统计学意义(P<0.05);呈迅速基底树枝样增强的良性病灶多于恶性病灶(14个vs.3个),差异有统计学意义(P<0.05)。结合良、恶性病灶超声造影特征,超声造影诊断恶性病灶的敏感性75.9%(41/54)、特异性62.9%(39/62)、准确率69.0%(80/116)。结论超声造影对鉴别诊断周围型肺局灶性病变的良恶性具有一定的临床价值。

ObjectiveTo investigate the clinical value of contrast-enhanced ultrasound in the differential diagnosisof benign and malignant peripheral pulmonary focal lesions.MethodsOne hundred and sixteen cases of peripheral pulmonaryfocal lesions confirmed by pathology in our hospital were selected,including 62 benign lesions and 54 malignant lesions.Thephase and mode of contrast-enhanced ultrasound in benign and malignant lesions were compared.ResultsThe enhancementphase of benign lesions was dominated by early enhancement(82.3%),while that of malignant lesions was dominated by lateenhancement(64.8%).The difference was statistically significant(P<0.05).The difference of contrast patterns between benignand malignant lesion was statistically significant(P<0.05),in which the number of malignant lesions enhanced by piecewisepatch was higher than that of benign lesions,the difference was statistically significant(37 lesions vs.23 lesions,P<0.05).Thenumber of benign lesions with rapid basal dendritic enhancement was higher than that of malignant lesions,and the differencewas statistically significant(14 lesions vs.3 lesions,P<0.05).Combined with the features of contrast-enhanced ultrasound ofbenign and malignant lesions,the sensitivity,specificity and accuracy of contrast-enhanced ultrasound in the diagnosis ofmalignant lesions were 75.9%(41/54),62.9%(39/62)and 69.0%(80/116),respectively.ConclusionContrast-enhancedultrasound has a certain clinical value in the differential diagnosis of peripheral pulmonary focal lesions.