超声及超声造影引导下粗针活检在周围型肺部病变中的应用

doi:10.7517/issn.1674-0475.220622

摘要/Abstract

摘要： 探讨超声及超声造影引导下粗针活检在周围型肺部病变中的应用价值。选择158例经CT或MRI诊断为周围型肺部病变的患者作为研究对象,将其分为常规超声组及超声造影组。常规超声组在普通超声引导下进行穿刺活检,超声造影组则在普通超声的基础上行超声造影检查,然后在其引导下行经皮穿刺活检。比较超声造影组与常规超声组穿刺成功率、病灶内坏死的显示率、亚型(分类)诊断准确率、表皮生长因子受体(EGFR)阳性率及穿刺术后并发症等情况。根据病理结果,超声造影组的成功率(100%)明显高于常规超声组(90%),P＜0.05。超声造影组的坏死显示率(46%)明显高于常规超声组(21%),P＜0.05。超声造影组的亚型(分类)诊断准确率(96%)略高于常规超声组(94%),差异无统计学意义(P＞0.05)。超声造影组的EGFR阳性率(32%)略低于常规超声组(35%),差异无统计学意义(P＞0.05)。超声及超声造影引导下穿刺对于周围型肺部病变的诊断具有重要价值,超声造影对于病灶与周边组织结构的关系及病灶内部的血流情况较常规超声更具优势,可有效提高穿刺成功率。

关键词: 超声造影, 穿刺活检, 周围型肺部病变

Abstract: This paper investigated the application value of ultrasound and contrast-enhanced ultrasound-guided coarse needle biopsy in peripheral pulmonary lesions. 158 patients with peripheral pulmonary lesions diagnosed by CT or MRI were selected as the research objects. They were divided into conventional ultrasound group and contrast-enhanced ultrasound group. The conventional ultrasound group underwent puncture biopsy under the guidance of ordinary ultrasound, while the contrast-enhanced ultrasound group underwent ultrasound contrast examination on the basis of ordinary ultrasound, and then percutaneous puncture biopsy under its guidance. The puncture success rate, the display rate of intrafocal necrosis, the diagnostic accuracy of subtype (classification), the positive rate of epidermal growth factor receptor (EGFR) and the complications after puncture were compared between the contrast-enhanced ultrasound group and the conventional ultrasound group. According to the pathological results, the success rate of contrast-enhanced ultrasound group (100%) was higher than that of conventional ultrasound group (90%), P<0.05. The display rate of necrosis in the contrast-enhanced ultrasound group (46%) was much higher than that in the conventional ultrasound group (21%), P<0.05. The diagnostic accuracy rate of subtype (classification) in the contrast-enhanced ultrasound group (96%) was slightly higher than that in the conventional ultrasound group (94%),the difference was not statistically significant (P>0.05). The positive rate of EGFR in the contrast-enhanced ultrasound group (32%) was lower than that in the conventional ultrasound group (35%),the difference was not statistically significant (P>0.05). Ultrasound and contrast-enhanced ultrasound-guided puncture are of great value in the diagnosis of peripheral lung lesions, and contrast-enhanced ultrasound has more advantages over conventional ultrasound in the relationship between the lesion and the surrounding tissue structure and the blood flow inside the lesion, which can effectively improve the success rate of puncture.

Key words: contrast-enhanced ultrasound, peripheral pulmonary lesions, peripheral lung lesions

朱鹏飞, 何英. 超声及超声造影引导下粗针活检在周围型肺部病变中的应用[J]. 影像科学与光化学, 2022, 40(6): 1349-1353.

ZHU Pengfei, HE Ying. The Role of Contrast-enhanced Ultrasound in Puncture Biopsy of Peri-pulmonary Lesions[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(6): 1349-1353.

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