超声造影定量参数与MSCT对肺良恶性病变鉴别诊断价值

Differential Diagnosis Value of ContrastEnhanced Ultrasound Quantitative Parameters and MSCT in Benign and Malignant Lung Lesions

目的比较超声造影定量参数与多层螺旋CT(MSCT)对肺良、恶性病变鉴别诊断价值。方法回顾性分析74例肺部肿块患者的超声造影定量分析及MSCT检查结果,其中肺良性病变38例纳入良性组、恶性病变36例纳入恶性组;比较两组超声造影、MSCT定量参数[上升时间(RT)、平均渡越时间(MTT)、峰值半降时间(TPH)、达峰时间(TTP)、峰值强度(PI)及上升支斜率(WlS)、血流量(BF)、血容积(BV)、平均通过时间(MTT)、表面渗透性(PS)];并绘制受试者工作特征(ROC)曲线比较各定量参数,诊断并鉴别肺良、恶性病变的曲线下面积值(AUC),记录临界值及敏感度、特异度。结果1)良性组与恶性组超声造影定量参数AT、RT、MTT、TPH、TTP、PI、WIS及MSCT定量参数BF比较差异无统计学意义(P>0.05);但良性组tAT、BV、MTT、PS显著低于恶性组,差异有统计学意义(P<0.05);2)超声造影定量参数中仅tAT、MTT、TPH、TTP的AUC值>0.60,且tAT的AUC值最高,并显著高于MTT、TPH,差异有统计学意义(P<0.05),以3.13s为临界值,tAT诊断鉴别肺良、恶性病变的敏感度、特异度分别为72.20%、100.00%;3)MSCT定量参数中BV的AUC值最高,并显著高于BF(Z=2.869,P=0.004),但与MTT、PS比较差异无统计学意义(P>0.05),以6.46mL/100g为临界值,BV诊断鉴别肺良、恶性病变的敏感度、特异度分别为75.00%、68.40%;4)tAT、BV的AUC值比较差异无统计学意义(Z=0.948、P=0.343)。结论超声造影定量参数tAT与MSCT定量参数BV诊断鉴别肺良、恶性病变的效能相当,值得临床重视。

Objective To compare differential diagnosis value of contrast-enhanced ultrasound(CEUS)quantitATive parameters and multi-slice spiral CT(MSCT)in benign and malignant lung lesions.Methods A retrospective analysis was performed on CEUS quantitATive analysis and MSCT results from 74 patients with pulmonary masses.38 patients with benign lung lesions were included in the benign group,while 36 patients with malignant lesions were included in the malignant group.CEUS and MSCT quantitATive parameters[rise time(RT),mean transit time(MTT),time from peak to one half(TPH),time to peak(TTP),peak intensity(PI),rising branch slope(WlS),blood flow(BF),blood volume(BV),mean transit time(MTT),permeability surface(PS)]were compared between the two groups.The receiver operating characteristic(ROC)curves were drawn to compare areas under the curve(AUC)of all quantitATive parameters for differential diagnosis of benign and malignant lung lesions.The cutoff values,sensitivity,and specificity were recorded.Results 1)There were no significant differences in CEUS quantitATive parameters(AT,RT,MTT,TPH,TTP,PI,WIS)or MSCT quantitative parameter BF between the benign group and malignant group(P>0.05).However,tAT,BV,MTT,and PS in the benign group were significantly lower than those in the malignant group(P<0.05).2)In CEUS quantitative parameters,only AUC values of tAT,MTT,TPH,and TTP were higher than 0.60.Moreover,the AUC of tAT was the highest,which was significantly higher than that of MTT and TPH(P<0.05).With 3.13s as critical value,sensitivity and specificity of tAT for differential diagnosis of benign and malignant lung lesions were 72.20%and 100.00%,respectively.3)In MSCT quantitative parameters,the AUC value of BV was the highest,which was significantly higher than that of BF(Z=2.869,P=0.004),there was no significant difference compared with that of MTT or PS(P>0.05).With 6.46mL/100g as critical value,sensitivity and specificity of BV for differential diagnosis of benign and malignant lung lesions were 75.00 and 68.40%,respectively.4)There was no significant difference in AUC between tAT and BV(Z=0.948,P=0.343).Conclusion The efficiency of CEUS quantitative parameter tAT and MSCT quantitative parameter BV is comparable in the differential diagnosis of benign and malignant lung lesions.