| OBJECTIVE: To investigate the diagnosis of peripheral lesions by contrast-enhanced ultrasonography and its percutaneous lung puncture The value of the application in the inspection.Methods: Seventy-one patients who underwent CT diagnosis of peri-pulmonary lesions and percutaneous lung biopsy were randomly divided into the conventional ultrasound group(control group)and the contrast-enhanced ultrasound group(experimental group).In the group(36cases),only routine ultrasound examination was performed before the needle biopsy,and conventional ultrasound examination and contrast-enhanced ultrasound examination were performed before the ultrasound contrast group(35cases).When the patients underwent routine ultrasonography on the lesions,the size,shape,internal echo and color flow of the lesions were recorded,and the lesions were roughly judged.In the experimental group,the contrast agent used in the contrast-enhanced ultrasound examination was sulphur hexafluoride(SonoVue)produced by Bracco,Italy,and the contrast agent perfusion and enhancement were observed in real time under low mechanical index.According to the pathological results,the benign group and the malignant group were further divided into two groups.The diameter,shape,internal echo,color flow of the lesions,and the type and quantitative parameters of the contrast enhancement in the contrast-enhanced ultrasound group were compared.The conventional ultrasound group and the ultrasound contrast group were compared.Positive rate of puncture pathology and complications.RESULTS: 1.A total of 71 lesions in 71 patients with peri-pulmonary lesions underwent ultrasound-guided percutaneous lung biopsy.62 patients were finally diagnosed with pathology,including 28 patients in the control group(22malignant lesions and 6 benign lesions).There were 34 cases in the experimental group(24 cases of malignant lesions and 10 cases of benign lesions).Retrospective analysis of the two groups of two-dimensional ultrasound findings of peripheral lesions of benign and malignant lesions maximum diameter comparison P <0.05,the difference was statistically significant.2.46 cases of malignant lesions in the control group and the experimental group,31 cases of uneven hypoechoic,15 cases of uniform hypoechoic;16cases of benign lesions,7 cases of uneven hypoechoic,and 9 cases of uniform hypoechoic.There was no significant difference in the two-dimensional sonogram echo between benign and malignant lesions(P=0.094>0.05).3.In the control group and the experimental group,the color flow signals of the lesions were graded,46 cases of malignant lesions,11 cases of grade 0,12 cases of grade I,18 cases of grade II,5 cases of grade III,16 cases of benign lesions,10 cases of grade 0,There were 5 cases of grade I,1 case of grade II,and 0 case of grade III.Comparing the color flow signals of benign andmalignant lesions,the difference was statistically significant(P=0.010<0.05).4.The enhancement of lesions in the experimental group,24 cases of malignant lesions,22 cases of uneven enhancement,and 2 cases of uniform enhancement.There were 10 cases of benign lesions,6 cases of uneven enhancement,and 4 cases of uniform enhancement.Comparing the enhancement types of benign and malignant lesions,the difference was statistically significant(P=0.048<0.05).5.In the comparison of the quantitative parameters of the CEUS TIC curve in the experimental group,the AT and t-AT of the benign group of the peripheral lung lesions were lower than the malignant group,the difference was statistically significant(p < 0.05),and the MMT benign group was higher than the malignant group.Statistically significant,TTP,L-AT,and PI were not statistically significant between the benign and malignant groups(p > 0.05).The ROC curve was drawn between the two groups with different quantitative parameters.The contrast agent reached the lesion-pulmonary tissue time difference(t-AT)with the highest diagnostic value.The area under the curve was 0.921,the optimal threshold was 2.05 s,t-AT? At 2.05 s,the sensitivity of CEUS real-time contrast observation for differential diagnosis of peripheral lung lesions was 87.5% and specificity was 90.0%.6.The success rate of puncture and the incidence of complications in the experimental group and the control group.The success rate of guided puncture in the ultrasound group was higher than that in the conventional ultrasound group(P=0.036<0.05).The difference was statistically significant.For the comparison(P=1.000>0.05),the difference was not statistically significant.Conclusion: 1.Conventional ultrasound color flow signal can be used for the preliminary judgment of benign and malignant lesions around the lung;2.Contrast-enhanced ultrasonography is very important for the differential diagnosis of benign and malignant lesions around the lung;3.Compared with conventional ultrasound,contrast-enhanced ultrasound can improve the positive rate of puncture pathology of peripheral lung lesions and reduce complications to a certain extent.4.The diameter of malignant lesions around the lung is greater than that of benign lesions. |
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