超声造影鉴别诊断肺周围型肿瘤性病变 与炎症性病变的研究

Application of contrast enhanced ultrasonography in differential diagnosis of peripheral lung tumors and inflammatory lesions

摘要:

目的 探讨超声造影（CEUS）在肺周围型肿瘤性病变与炎症性病变临床鉴别的意义及临床应用 价值。方法 收集该院因肺部肿块住院患者，按增强CT 扫描结果，选取肺周围型肿块患者45 例，行常规超声 和CEUS 检查，使用实时超声造影成像对比脉冲序列技术（CPS）评价CEUS 在肺周围型肿瘤性病变与炎症 性病变鉴别诊断中的临床价值。结果 肺部炎症性病变实性部分血管分布均匀，造影后呈均匀增强。肿瘤性 病变血管迂曲、动静脉吻合形成、组织坏死导致造影后不均匀增强。肿瘤性病变始增时间与达峰时间慢于炎 症性病变。肿瘤性病变峰值强度低于炎症性病变，组间比较差异有统计学意义（P <0.05）。肿瘤性病变下降 支斜率为（3.52±1.65）%，炎症性病变下降支斜率为（2.75±1.39）%；肿瘤性病变上升支斜率为（10.19±1.29）%， 炎症性病变上升支斜率为（11.57±2.97）%，下降支斜率和上升支斜率组间比较差异均无统计学意义（P >0.05）。 结论 超声造影对肺部肿瘤性病变与炎症性病变临床鉴别具有重要作用。

Abstract:

Objective To investigate the clinical value of contrast-enhanced ultrasonography (CEUS) in differential diagnosis of peripheral lung tumors and inflammatory lesions. Methods Forty-five patients with pulmonary peripheral masses were collected according to the results of enhanced CT scans. And conventional ultrasonography and CEUS were used to test the lesions. The contrast pulse sequence (CPS) was used to evaluate the clinical value of CEUS in the differential diagnosis of peripheral lung tumors and inflammatory lesions. Results The distribution of blood vessels in the pulmonary inflammatory lesions was uniform enhancement after angiography. In tumors, tortuous vessels, arteriovenous anastomosis formation and tissue necrosis leaded to inhomogeneous enhancement after angiography. The enhancement time and washout time of the benign masses were faster than those of the malignant tumors, and the maximum intensity of the benign masses was higher than that of the malignant tumors (P < 0.05). The slope of the descending branch of the tumor lesions was (3.52 ± 1.65)%, and that of the inflammatory lesions was (2.75 ± 1.39)%; the slope of the ascending branch of the tumor lesions was (10.19 ± 1.29)%, and that of the inflammatory lesions was (11.57 ± 2.97)%; there were no statistically significant differences between the two groups (P > 0.05). Conclusions CEUS can help to differentiate peripheral lung tumor lesions from inflammatory lesions in clinic.