超声造影评价肺腺癌与肺鳞癌血流灌注特征的价值研究

Value of contrast-enhanced ultrasonography in evaluating blood perfusion characteristics of pulmonary adenocarcinoma and squamous cell carcinoma

目的对比分析肺腺癌与肺鳞癌超声造影增强特征,探讨超声造影评价肺腺癌与肺鳞癌血流灌注特征差异的应用价值。方法回顾性选取2017年10月至2021年12月于山西医科大学第二医院经病理确诊的54例(54个病灶)肺腺癌与46例(46个病灶)肺鳞癌患者,采用χ2检验对比分析二者超声造影增强特征的差异,包括增强时相(肺动脉增强、支气管动脉增强)、增强模式(基底树枝型增强、杂乱血管型增强)及达峰模式(均匀型增强、不均匀型增强)。结果肺腺癌与肺鳞癌超声造影增强特征呈现一定差异,增强时相表现为肺动脉增强的病灶肺腺癌(70.4%,38/54)多于肺鳞癌(45.7%,21/46);增强模式表现为基底树枝型增强的病灶肺腺癌(20.4%,11/54)多于肺鳞癌(4.3%,2/46);达峰模式表现为不均匀型增强的病灶肺鳞癌(67.4%,31/46)多于肺腺癌(16.7%,9/54),差异均具有统计学意义(χ^(2)=6.274、5.638、26.630,P=0.012、=0.018、<0.001)。结论肺腺癌与肺鳞癌的超声造影增强特征存在一定差异,超声造影可评估二者血流灌注差异,对其临床治疗方案的选择及鉴别诊断具有潜在的临床应用价值。

Objective To compare and analyze the enhancement characteristics of pulmonary adenocarcinoma(ADC)and squamous cell carcinoma(SCC)on contrast-enhanced ultrasonography(CEUS),and to investigate the value of CEUS in evaluating the differences in blood perfusion characteristics of ADC and SCC.Methods A total of 54 patients with pulmonary ADC and 46 patients with SCC confirmed by pathology at the Second Hospital of Shanxi Medical University from October 2017 to December 2021 were retrospectively selected.The chi-square test was used to compare the CEUS characteristics between pulmonary ADC and SCC,including the enhancement phase(early pulmonary-arterial[PA]pattern of enhancement,delayed bronchial-arterial[BA]pattern of enhancement),enhancement pattern(basal dendritic enhancement,chaotic vascular enhancement),and peak pattern of CEUS(homogeneous enhancement,inhomogeneous enhancement).Results There were some differences in the enhancement characteristics between ADC and SCC,with more ADC(70.4%,38/54)than SCC(45.7%,21/46)cases showing PA pattern of enhancement in the enhancement phase;more ADC(20.4%,11/54)than SCC(4.3%,2/46)cases showing basal dendritic enhancement in the enhancement pattern;and more SCC(67.4%,31/46)than ADC(16.7%,9/54)cases showing inhomogeneous enhancement in the peak pattern;the differences were statistically significantχ^(2)=6.274,5.638,and 26.630;P=0.012,=0.018,and<0.001,respectively).Conclusion There are some differences in enhancement characteristics of CEUS between ADC and SCC.CEUS can evaluate the differences in blood perfusion characteristics between them,and has potential clinical value in the selection of treatment plan and differential diagnosis of ADC and SCC.