超声小探头探查5、6级支气管路径对肺结节诊断的价值

The value of ultrasonic small probe exploration of the 5th and 6th bronchial pathways on lung nodule biopsy

目的 探讨超声小探头诊断5、6级支气管相关肺结节的影响因素。方法 收集2022年1月—2023年10月于临沂市人民医院薄层CT诊断肺外周结节的患者49例。薄层CT判断肺结节相关5级或6级支气管、测量结节的直径,评估实性结节、单纯磨玻璃结节。超声小探头测量5级管口到结节的距离、测量支气管相关结节的长度,判断超声小探头与结节的位置,统计分析以上因素对活检结果的影响。结果 49例患者活检阳性率79.59%,超声小探头测量结节的长度阳性组15.0(10.0,23.0)mm,阴性组11.0(2.0,20.8)mm(z=-11.220 P=0.022)。超声小探头在结节内部阳性率90.33%明显高于超声小探头在结节边缘的阳性率61.11%(χ^(2)=5.982,P=0.014)。CT测量结节的直径阳性组22.0(16.0,29.0)mm阴性组19.5(15.0,30.0)mm(z=-5.261,P=0.017)。性别、年龄、5级管口到结节的距离、实性结节、磨玻璃结节、5级支气管肺相关结节、6级支气管相关肺结节对活检阳性结果影响无统计学差异。结论 CT测量肺结节直径越大,超声小探头经5、6支气管测得肺结节长度越长,超声图像呈同心圆样改变,活检阳性率越高。

Objective To investigate the factors af fecting the diagnosis of grade 5 and 6 broncho-associated pulmonary nodules by small ultrasonic probe.Methods A total of 49 patients with peripheral pulmonary nodules diagnosed by thin slice CT in Linyi People's Hospital from 2022.01 to 2023.10 were collected.Thin-slice CT was used to determine grade 5 or 6 bronchus associated with pulmonary nodules,measure the diameter of nodules,evaluate solid nodules and simple ground glass nodules.The distance from the grade 5 opening to the nodule and the length of the bronchial associated nodule were measured by the ultrasonic small probe,and the positions of the ultrasonic small probe and nodule were determined.The influence of the above factors on the biopsy results was statistically analyzed.Results The positive rate of biopsy in 49 patients was 79.59%.The nodule length measured by small ultrasonic probe was 15.0(10.0,23.0) mm in the positive group and 11.0(2.0,20.8) mm in the negative group(z =-11.220,P = 0.022).The positive rate of the small ultrasound probe in the interior of the nodules was 90.33%,which was significantly higher than that of the small ultrasound probe in the edge of the nodules (χ^(2)=5.982,P = 0.014).The diameter of nodules measured by CT was 22.0(16.0,29.0) mm in the positive group and 19.5(15.0,30.0) mm in the negative group(z =-5.261,P =0.017).Gender,age,distance from Grade 5 to nodule,solid nodule,ground glass nodule,grade 5 bronchopulmonary nodule and grade 6 bronchopulmonary nodule had no significant difference in positive biopsy results.Conclusion The larger the diameter of lung nodules measured by CT,the longer the length of lung nodules measured by small ultrasound probe through the 5th and 6th bronchus,the concentric changes in ultrasound images,and the higher the positive rate of biopsy.