超声造影与高分辨率CT鉴别诊断周围型肺肿物的价值

Value of Contrast-enhanced Ultrasound and High-resolution CT in Differential Diagnosis of Peripheral Lung Tumors

目的探讨超声造影与高分辨率CT鉴别诊断周围型肺肿物良恶性的价值。方法回顾性分析73例(74个病灶)周围型肺肿物患者,观察病灶的二维超声特征、超声造影表现及高分辨率CT影像特征,以病理结果为金标准,分别计算二维超声、CEUS及HRCT诊断的敏感性、特异性、诊断准确率,绘制受试者工作特征(ROC)曲线,评价超声造影与高分辨率CT鉴别周围型肺肿物良恶性的诊断效能。结果恶性组患者平均年龄高.于良性组,病灶好发于右肺上叶,直径较大(P<005);恶性组超声表现为球形或类球形,造影表现为不均匀高增强,向心样灌注,呈慢进快出模式,良性组超声表现为楔形或三角形,造影表现为均匀.等或低增强,树枝样灌注,呈快进快出模式(P<00.5);3种.方法受.试者工作曲线下面积(AUC)分别为0627.、0808、.0800,CEUS的灵.敏度及.诊断准确率(776%、797%).低于HRCT(959%.、851%),但CEUS的特异度(840%)高于HRCT(640%)。结论超声造影鉴别诊断周围型肺肿物的良恶性有一定的价值,且与HRCT诊断效能相当,可作为影像学技术的有效补充检查手段。

Objective To explore the diagnostic value of contrast-enhanced ultrasound(CEUS)and High resolution CT(HRCT)images in the diagnosis of benign and malignant peripheral lung tumors.Methods Retrospective analysis of 73 patients(74 lesions)with surrounding pulmonoma,Analyze the differences in two-dimensional ultrasound features,contrast-enhanced ultrasound and high-resolution CT image features between benign and malignant lesion,and calculate the sensitivity,specificity,and diagnosis of two-dimensional ultrasound,CEUS,and HRCT respectively Accuracy,positive predictive value,negative predictive value,draw receiver operating characteristic(ROC)curve,and evaluate the diagnostic efficacy of contrast-enhanced ultrasound versus high-resolution CT for benign and malignant peripheral lung tumors.Results The average age of the patients in the malignant group was higher than that in the benign group,and the lesions were more likely to occur in the upper lobe of the right lung,with a larger diameter(P<0.05);in the malignant group,the ultrasound showed spherical or quasi-spherical shape,and the contrast showed uneven high-enhancement and centripetal perfusion.It was in a slow-in and fast-out mode,the benign group showed a wedge or triangle on ultrasound,and the contrast showed uniform or low-enhancement,tree-like perfusion,in a fast-in and fast-out mode(P<0.05);The area under the receiver operating curve(AUC)of the three methods are 0.627,0.808,and 0.800,respectively.The sensitivity and diagnostic accuracy of CEUS(77.6%,79.7%)are lower than that of HRCT(95.9%,85.1%),but CEUS is specific Degree(84.0%)is higher than HRCT(64.0%).Conclusion Contrast-enhanced ultrasound has a certain value of good malignant peripheral lungs and is comparable to HRCT diagnostic efficacy,and can be used as an effective supplemental inspection method for imaging technology.