The Role Of Contrast-enhanced Ultrasound In Diagnosis And Assessment Of Chemotherapy In Peripheral Lung Cancer

Part one Conventional ultrasonography of Primary,peripheral lung cancerObjective To analyze the conventional ultrasound of Primary,peripheral lung cancer.Methods Analysis of conventional ultrasound of 174 cases of lung cancer patients,including the lesion site,size,shape,such as(irregular,spherical),echo(low and high,mixing,no echo),internal necrosis,internal flow,bronchial gas phase,tumor size and divided into < 3 cm,3 ~ 5 cm,> 5 cm group,analysis of different size differences between the sonographic findings of lung cancer.Analyze the ultrasound manifestations of 174 patients with lung cancer,including the location,size,morphology(irregular,spherical),echo(low/high/ mixed/ no echo),internal necrosis,CDFI,bronchial gas phase,The tumor size was divided into groups of <3cm,3 ~ 5cm,and> 5cm,The differences of ultrasound manifestations of different sizes of lung cancer were analyzed.Results The conventional ultrasound of lung cancer are spheroidal and irregular,mostly spheroidal,mainly hypoechoic,homogeneous,rare bronchial gas phase,no obvious blood flow signal.The diameter of squamous cell carcinoma was > 5cm,and that of adenocarcinoma was 3~5cm(P < 0.05).There were significant differences in morphology,echo,internal necrosis and internal blood flow of lung cancer with different diameters(P < 0.05),while there were no significant differences in lung cancer location and bronchial gas phases with different diameters(P> 0.05).Part two CEUS in assessment of vascularization in Primary,Peripheral Lung CancerObjective CEUS was used to assess the vascularization of Primary,Peripheral lung cancer,and to compare the differences between the CEUS enhancement modes of lung cancer with different blood vessels,and to compare the pathological types of lung cancer with different blood vessels.Methods Analysis of CEUS of 174 patients with lung cancer.Real-time comparative observation method was used to compare the enhancement time of lung cancer and adjacent lung tissue to determine the enhancement phase of CEUS: lung cancer and adjacent normal lung tissue were enhanced at the same time or earlier than lung tissue enhancement,At this stage,the tumor is dominated by pulmonary artery blood supply,the lesion is later than the surrounding lung tissue enhancement and is determined to be the bronchial artery stage,and the tumor is dominated by bronchial artery blood supply.To compare the difference between the type of blood supply artery and CEUS enhancement mode,and to compare with the pathological type.Results Lung cancer is mainly supplied by bronchial arteries,but the pulmonary artery is also involved.Different blood supply of lung cancer is related to their pathological types: squamous cell carcinoma,small cell lung cancer and other rare types of NSCLC are mainly supplied by bronchial arteries.Adenocarcinoma was supplied by pulmonary artery and bronchial artery together(P < 0.001).The lesions of pulmonary artery blood supply mainly showed homogeneous high enhancement,the lesions of bronchial artery blood supply showed uneven low enhancement,and internal necrosis was common(P < 0.001).Part three CEUS in assessment of chemotherapy efficacy in peripheral lung cancerObjective To explore the feasibility of CEUS in assessment of chemotherapy efficacy in peripheral lungMethods 30 patients underwent CEUS examination before and at the end of one chemotherapy cycle.The changes of tumor length diameter,short diameter and average diameter of 30 patients before and after chemotherapy were compared.The chemotherapy effect shown by CT before and after chemotherapy was taken as the reference standard for efficacy evaluation.The consistency of CEUS efficacy evaluation results and CT evaluation results was evaluated by kappa test,and the differences of rise time(AT),peak intensity(PI),AUC and TTP before and after chemotherapy were compared.Results After chemotherapy,30 patients were divided into remission group(15 cases)and non remission group(15 cases).After chemotherapy,the tumor length diameter,short diameter and average diameter in remission group decreased(P < 0.05).The results of CEUS efficacy evaluation were consistent with those of CT(K = 0.641).PI in the remission group after chemotherapy was lower than that of the non-remission group(P < 0.05),There was no change in AT,AUC and TTP before and after chemotherapy(P > 0.05).Conclusion(1)the conventional manifestations of peripheral lung cancer have certain characteristics;(2)CEUS can be used to evaluate the vascularization of Primary,Peripheral lung cancer is mainly supplied by the bronchial artery,but not only by the bronchial artery,which is related to its pathological type;The CEUS of lung cancer with different blood supply was different.(3)CEUS can be used for early evaluation of chemotherapy effect in patients with lung cancer.