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目的探讨超声造影在周围型肺部病变的病因鉴别及超声引导下经皮肺活检中的应用价值。方法对34例肺周围型肺部病变患者常规超声检查后,对病变部位进行超声造影,并在造影不同增强区域进行超声引导下经皮肺活检,根据病变的病理类型,分析良恶性病变的超声造影成像模式。结果 (1)超声造影:根据造影剂分布情况分3型,Ⅰ型均匀增强型14例;Ⅱ型不均匀增强型18例;Ⅲ型环状增强型2例。根据开始增强时间分3型,Ⅰ型7~9s6例;Ⅱ型10~15s24例;Ⅲ型>15s4例。(2)超声引导下穿刺活检周围型肺部病变的病理诊断结果:恶性26例:分别为腺癌14例,鳞癌4例,小细胞神经内分泌癌5例,淋巴瘤1例,间皮瘤2例;良性8例:炎症4例,炎性假瘤2例,萎缩肺组织2例。结论 (1)周围型肺部病变超声造影时间-强度曲线开始增强时间的差异,对良恶性病变的鉴别有一定的诊断价值。(2)根据超声造影显示高增强区域进行穿刺,提高了穿刺活检的阳性率,为正确指导治疗提供了充分的理论依据。
Objective To investigate the etiological factors of ultrasonography in peripheral pulmonary lesions and the value of ultrasound-guided percutaneous lung biopsy. Methods Thirty-four patients with pulmonary-related pulmonary disease underwent routine ultrasonography. Ultrasound imaging was performed on the lesion site. Ultrasound-guided percutaneous lung biopsy was performed in different regions of contrast enhancement. According to the pathological types, the ultrasonographic features of benign and malignant lesions were analyzed. Contrast imaging mode. Results (1) Contrast ultrasound: according to the distribution of contrast agent type 3, type Ⅰ uniform enhancement in 14 cases; type Ⅱ uneven enhancement in 18 cases; type Ⅲ ring enhancement in 2 cases. According to the beginning of time to enhance the type 3, type Ⅰ 7 ~ 9s6 cases; type Ⅱ 10 ~ 15s24 cases; Ⅲ type> 15s4 cases. (2) Ultrasound guided biopsy pathological diagnosis of peripheral pulmonary lesions: 26 cases of malignant: adenocarcinoma were 14 cases, squamous cell carcinoma in 4 cases, 5 cases of small cell neuroendocrine carcinoma, 1 case of lymphoma, mesothelioma 2 cases; benign 8 cases: 4 cases of inflammation, inflammatory pseudotumor in 2 cases, 2 cases of atrophic lung tissue. Conclusions (1) The difference of contrast enhancement time between the time-intensity curve of CEUS and peripheral pulmonary lesions has some diagnostic value in differentiating benign and malignant lesions. (2) According to the contrast-enhanced ultrasound-enhanced area, we can improve the positive rate of biopsy and provide a sufficient theoretical basis for the correct guidance and treatment.