摘要
目的探讨高频超声造影引导周围型肺实变穿刺活检的临床应用价值。方法回顾性分析高频超声造影穿刺活检的33例周围型肺实变患者的临床资料。以病理结果为金标准,对穿刺路径、针尖显示、穿刺并发症和病理结果诊断率方面进行描述。结果33例患者中,32例穿刺获得病理结果,其中恶性病变18例,良性病变14例,未取得有效组织1例。①病变增强与周围肺组织增强时间差异<2.5 s者20例(良性12例,恶性8例),>2.5 s者12例(良性2例,恶性10例)。病变均匀强化者19例,其中良性9例(28.1%),恶性10例(31.3%);不均匀强化者13例,其中良性5例(15.6%),恶性8例(25.0%)。均匀强化者与非均匀强化者良、恶性的比例差异无统计学意义(P=0.618)。②高频超声造影图像评分在2分以上者28例(87.5%),高频超声造影评估图像满意。③介入穿刺路径评分在2分以上者29例(90.6%)。④穿刺针尖显示评分在1分以上者28例(87.5%)。⑤共穿刺87针,32例获得穿刺病理诊断(97.0%,32/33)。结论高频超声造影效果满意,可清晰判读病变灌注的不同时相,帮助选择活检靶区;高频超声引导介入穿刺时,清晰显示胸壁细微结构,避免医源性损伤。
Objective To explore the clinical application value of high-frequency contrast-enhanced ultrasound in guiding peripheral lung consolidation biopsy.Methods Clinical data of 33 patients with peripheral pulmonary who underwent high-frequency contrast-enhanced ultrasound biopsy were retrospectively analyzed.According to the pathological results as the gold standard,the puncture path,needle tip display,puncture complications and the diagnostic rate of pathological results were described.Results Among the 33 patients,32 patients had pathological findings,including 18 malignant lesions,14 benign lesions,and 1 non-effective tissue.①The difference between lesion enhancement and peripheral lung tissue enhancement time within 2.5 s were in 20 patients(12 benign,8 malignant),12 patients(2 benign,10 malignant)showed difference greater than 2.5 s.There were 19 cases with uniform enhancement,including 9 benign cases(28.1%),10 malignancy cases(31.3%);13 cases with uneven enhancement,including 5 cases with benign(15.6%),8 cases with malignancy(25.0%).The rate of relatively uneven enhancement of malignant lesions was higher,but the difference was not statistically significant(P=0.618).②High-frequency contrast-enhanced images were scored at 2 points or more in 28 cases(87.5%),and the high-frequency contrast-enhanced ultrasound images were satisfactory.③Interventional puncture path score was 2 points or more in 29 cases(90.6%).④Puncture needle tip display were scored at 1 point or more in 28 cases(87.5%).⑤A total of 87 needles were punctured,and 32 cases obtained pathological diagnosis of puncture(97.0%,32/33).Conclusions Due to its high spatial resolution,high-frequency ultrasound can avoid adjacent tissues and blood vessels by showing the position of the needle tip in real time without the need of puncture frame and multi-angle needle insertion during operation,and accurately locate the target with good safety.
作者
张园园
谭石
孙彦
付颖
王淑敏
傅强
崔立刚
Zhang Yuanyuan;Tan Shi;Sun Yan;Fu Ying;Wang Shumin;Fu Qiang;Cui Ligang(Department of Ultrasound,Peking University Third Hospital,Beijing 100191,China;Department of Ultrasound,General Hospital of Taiyuan Iron and Steel (Group) Co.,LTD,Taiyuan 030003,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2019年第6期517-520,共4页
Chinese Journal of Ultrasonography
关键词
超声造影
高频超声
肺
穿刺活检
Contrast-enhanced ultrasound
High-frequency ultrasound
Lung
Puncture biopsy
