超声造影鉴别诊断周围型肺局灶性病变的临床价值

The Clinical Value of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Peripheral Focal Lung Lesions

目的:探究超声造影鉴别诊断周围型肺局灶性病变的临床价值。方法:选取2022年1月~2023年12月本院收治的经活检病理、CT增强扫描确诊为周围型肺局灶性病变患者60例,对所有患者进行超声造影检查,观察诊断结果。结果:所有患者经活检病理检查结果中良性病变占55.00%(33例),恶性病变占45.00%(27例)。对良性、恶性病灶增强时相分析对时发现具有一定差异,良性病灶以早期增强为主,高达81.82%(27例),较恶性病灶中的26.63%(8例)更高(P<0.05),恶性病灶以晚期增强为主,高达66.67%(18例),较良性病灶中的12.12%(4例)更高(P<0.05)。良性、恶性病灶之间造影模式具有差异,良性病灶以树枝状增强为主,高达63.64%(21例),较恶性病灶中的14.81%(4例)更高(P<0.05),恶性病灶以向心性增强为主,高达62.69%(17例),较良性病灶中的3.30%(1例)更高(P<0.05)。恶性病灶中肺鳞癌、肺腺癌之间各增强时相、造影模式均无显著差异(P>0.05)。对恶性病灶敏感性74.07%,病灶诊断准确率71.67%。具有一定辅助诊断作用。结论:超声造影在鉴别诊断周围型肺局灶性病变中可根据病灶时相特点及造影模式对周围型肺局灶性病变良性、恶性进行区分,具有一定应用价值。

Objective:To explore the clinical value of contrast-enhanced ultrasound in the differential diagnosis of peripheral focal lung lesions.Methods:60 patients diagnosed with peripheral focal lung lesions through biopsy pathology and CT enhanced scanning who were admitted to our hospital from January 2022 to December 2023 were selected.All patients underwent contrast-enhanced ultrasound examination and the two groups were compared.Results:Among all patients,benign lesions accounted for 55.00%(33 cases)and malignant lesions accounted for 45.00%(27 cases)in the pathological examination results of biopsy.When analyzing the enhancement phase of benign and malignant lesions,it was found that there were certain differences.Early enhancement was predominant in benign lesions,up to 81.82%(27 cases),higher than 26.63%(8 cases)in malignant lesions(P<0.05),while late enhancement was predominant in malignant lesions,up to 66.67%(18 cases),higher than 12.12%(4 cases)in benign lesions(P<0.05).There were differences in imaging patterns between benign and malignant lesions.Benign lesions mainly exhibit dendritic enhancement,up to 63.64%(21 cases),which was higher than 14.81%(4 cases)in malignant lesions(P<0.05),while malignant lesions mainly exhibit centripetal enhancement,up to 62.69%(17 cases),which was higher than 3.30%(1 case)in benign lesions(P<0.05).There was no significant difference in enhancement phase and contrast mode between lung squamous cell carcinoma and lung adenocarcinoma in malignant lesions(P>0.05).The sensitivity to malignant lesions was 74.07%,and the accuracy of lesion diagnosis is 71.67%.It has a certain auxiliary diagnostic function.Conclusion:Contrast-enhanced ultrasound can distinguish benign and malignant peripheral pulmonary focal lesions based on the temporal characteristics and contrast mode of the lesions,and has certain application value in the differential diagnosis of peripheral pulmonary focal lesions.