| Objective To investigate the application value of conventional ultrasound and contrast-enhanced ultrasound in subpleural lung lesions.Method A total of 298 cases of ultrasound-guided puncture biopsy of subpleural lung lesions in our hospital from December 2018 to December 2021 were included in the study and analyzed divided into conventional ultrasound group（209 cases）and contrast-enhanced ultrasound group（89 cases）,including conventional ultrasound group only line immediately following conventional ultrasound biopsy,contrast-enhanced ultrasound group need to conventional ultrasound and ultrasound imaging examination,and then to biopsy Two groups of lesions in routine ultrasound examination,to observe and record the pathological changes of ultrasonic ultrasonographic features,including side don’t form boundary.Comparison of puncture accuracy and incidence of complications between the two groups.With pathological results as the gold standard,the CEUS group was divided into benign group and malignant group.Retrospective analysis of CEUS performance of the two groups included enhancement mode,enhanced uniformity,contrast agent arrival time（AT）.The time for contrast agent to reach the adjacent lung tissue and the time difference between the contrast agent and the adjacent lung tissue（ΔT）,and ROC curve analysis of meaningful quantitative parameters.Result Among 298 cases of subpleural lung lesions underwent ultrasound-guided percutaneous biopsy,275 cases were confirmed pathological diagnosis,including 188 cases in the conventional ultrasound group（119 cases in the malignant group,69 cases in the benign group）and 87 cases in the contrast-enhanced ultrasound group（53 cases in the malignant group,34 cases in the benign group）.Ultrasonic manifestations of benign and malignant lung lesions were analyzed in morphology.There were statistically significant differences in air bronchial sign and blood flow（all P values<0.05）.There were no statistically significant differences in the echo inside the lateral boundary between the two groups（all P values>0.05）.The puncture accuracy of conventional ultrasound group and CEUS group was 89.95%and 97.75%,respectively,the difference was statistically significant（P<0.05）;The complication rates were 4.31%and 2.25%,respectively,and the difference was not statistically significant（P>0.05）.The results showed that dendrite and mixed perfusion modes were dominant in benign group（88.24%）,while centralizing and mixed perfusion modes were dominant in malignant group（83.02%）.There was no significant difference in the enhancement uniformity between benign group and malignant group（P>0.05）.AT was（5.43±2.23）s（8.37±1.80）s in benign and malignant groups,and the difference was statistically significant（P<0.05）.The time for contrast agent to reach adjacent lung tissue in malignant group（4.12±1.14）s,and in benign group（3.95±1.18）s,there was no statistical significance（P>0.05）.The time difference（ΔT）between the lesions and adjacent lung tissues of benign and malignant groups was（1.48±1.55）s（4.24±1.73）s,respectively,and the difference was statistically significant（P<0.05）.The area under ROC curve of the time difference between the arrival time of contrast agent（AT）the lesion and adjacent lung tissue（ΔT）was 0.799 and 0.921,respectively.The optimal time cutoff points determined by Youden index were 6.73s and 2.45s,respectively,and the sensitivity and specificity were 71.7%83.0%and 79.4%85.3%.The time lag（ΔT）between the arrival of contrast agent to the lesion and adjacent lung tissue was the highest,and the area under the curve was the largest.Conclusions1.Conventional ultrasonography can provide certain information for benign and malignant diagnosis of subpleural lung lesions;2.contrast-enhanced ultrasound is of great value in differentiating benign and malignant subpleural lung lesions.3.CEUS can further improve the puncture accuracy of subpleural lung lesions compared with conventional ultrasound-guided puncture biopsy... |
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