病灶—肺组织造影剂始增时间差对胸膜下肺病变的诊断价值

Diagnostic value of lesion-lung tissue contrast medium arrival time difference in subpleural lung lesions

目的:探讨病灶—肺组织造影剂始增时间差在诊断胸膜下肺良恶性病变的诊断价值。方法:回顾性分析2021年1~9月在广西医科大学第一附属医院发现胸膜下肺病变患者145例,均行穿刺活检或手术。根据病理结果,分为良性组61例和恶性组84例。所有患者均行超声造影,注入造影剂后应用时间—强度曲线分析软件记录病灶、肺组织和胸壁的始增时间(AT),计算病灶—肺组织始增时间差及胸壁—肺组织始增时间差,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)及最佳截断值。结果:病灶AT及病灶—肺组织始增时间差在良性组和恶性组间比较,差异有统计学意义(P<0.05),且恶性组均大于良性组。肺组织AT、胸壁AT和胸壁—肺组织始增时间差在两组间比较,差异无统计学意义(P>0.05)。病灶AT及病灶—肺组织始增时间差的AUC分别为0.691、0.762,最佳截断值分别为5.905、2.560,病灶AT的敏感度和特异度分别为0.798、0.557,病灶—肺组织始增时间差的灵敏度和特异度分别为0.714、0.754。结论:病灶—肺组织造影剂始增时间差对胸膜下肺良恶性病变具有一定的诊断效能,且优于病灶始增时间,对胸膜下肺病变的良恶性鉴别诊断具有一定的临床价值。

Objective:To investigate the value of lesion-lung tissue contrast medium arrival time difference in the diagnosis of benign and malignant subpleural lung lesions.Methods:Data of 145 patients with subpleural lung lesions treated in our hospital from January to September 2021 were analyzed retrospectively.All patients underwent needle biopsy or surgery.According to the pathological results,they were divided into benign group(61 cases)and malignant group(84 cases).All patients underwent contrast-enhanced ultrasound.The arrival time(AT)of lesions,lung tissue and chest wall were recorded by time-intensity curve analysis software,the lesionlung tissue AT difference and the chest wall-lung tissue AT difference were calculated.The receiver operating characteristic(ROC)curve was drawn,and the area under the ROC curve(AUC)and the best cut-off value were calculated.Results:The lesion AT and lesion-lung tissue AT difference between the two groups were statistically significant,and they were greater in the malignant group compared to the benign group(P<0.05).There were no significant differences in lung tissue AT,chest wall arrival time and chest wall-lung tissue AT between the two groups(P>0.05).The AUC of lesion AT and lesion-lung tissue AT difference were 0.691 and 0.762,respectively.The best cut-off values were 5.905 and 2.560,respectively.The sensitivity and specificity of lesion AT were 0.798 and 0.557 respectively,and the sensitivity and specificity of lesion-lung tissue AT difference were 0.714 and 0.754 respectively.Conclusion:The lesion-lung tissue contrast medium AT difference has a certain diagnostic efficiency for benign and malignant subpleural lung lesions,and is superior to the lesion AT.It has a certain clinical value for differential diagnosis of benign and malignant subpleural lung lesions.