始增时间差在肺周围型病变良恶性鉴别中的应用价值

Application value of arrival time difference in differential diagnosis of benign and malignant peripheral pulmonary lesions

目的:探讨始增时间差(T_(AT))在肺周围型病变良恶性鉴别中的应用价值。方法:选取CT发现肺周围型病变且行超声造影检查的50例患者,按病理结果分为恶性组29例及良性组21例。观察2组病变的二维超声图像及超声造影图像,TIC对造影定量参数进行分析。结果:①单因素分析示,2组病变始增时间(AT_(2))、T_(AT)及造影增强模式差异均有统计学意义(均P<0.05);②logistic回归模型示,T_(AT)与肺周围型病变的良恶性密切相关,且呈正相关(β=0.316,P<0.05);③绘制T_(AT)及AT_(2)的ROC曲线,AUC分别为0.750、0.710,最佳截断值分别为2.0、12 s,敏感度分别为93.1%、82.8%,特异度分别为61.9%、66.5%。结论:T_(AT)在鉴别肺周围型病变的良恶性方面具有较高的敏感度,当T_(AT)<2.0 s时倾向诊断为良性病变,而≥2.0 s时倾向诊断为恶性病变,值得临床推广。

Objective:To explore the application value of the arrival time difference(T_(AT))in the differential diagnosis of the benign and malignant peripheral pulmonary lesions.Methods:Fifty patients with peripheral pulmonary lesions detected by CT were selected for contrast-enhanced ultrasound(CEUS)examination.According to pathological findings,50 patients were divided into the malignant group(29 cases)and the benign group(21 cases).Two-dimensional images and CEUS images were observed,and the quantitative parameters of CEUS were analyzed with TIC.Results:Single factor analysis showed the arrival time of lesion(AT_(2)),T_(AT)and enhanced pattern of the two groups were statistically different(all P<0.05).Logistics regression model showed that T_(AT)was closely and positively correlated with the benign and malignant lesions(β=0.316,P<0.05).The ROC curve of T_(AT)and AT_(2)were drawn,with the AUC of 0.750 and 0.710,the optimal cutoff value of 2.0 and 12 s,the sensitivity of 93.1%and 82.8%,the specificity of 61.9%and 66.5%,respectively.Conclusions:T_(AT)has a high sensitivity in the differential diagnosis of benign and malignant peripheral pulmonary lesions.When T_(AT)is less than 2.0 s,it tends to be benign lesions,and when T_(AT)is greater than or equal to 2.0 s,it tends to be malignant,which is worth promoting clinically.