CAJ | 학술논문

目的：探讨超声造影（contrast enhanced ultrasound，CEUS）在经皮肺穿刺活检的临床应用价值。方法132例肺周占位的患者进行超声引导下经皮肺穿刺活检。其中72例患者穿刺前进行CEUS检查，为造影组；之前60例未进行CEUS检查，为对照组。比较两组超声图像特点，穿刺活检次数，病理诊断准确率以及并发症等方面的差异，分析CEUS对提高经皮肺穿刺活检成功率的应用价值。结果造影组肺周病灶内部坏死的显示率为44.4%（32/72），高于对照组的6.7%（4/60），差异有统计学意义（P <0.01）。在造影组中，12.5%（9/72例）显示病灶伴局部不张肺组织，CEUS可清楚显示位于不张肺组织内的病灶，对照组为1.7%（1/60例），两组差异具有统计学意义（P <0.05）。造影组对照病理，诊断正确率为95.8%（69/72），高于对照组的80%（48/60），差异有显著统计学意义（P<0.01）。两组穿刺次数分别为（2.4±0.6）次和（2.6±0.6）次，差异无统计学意义。并发症情况比较，两组发生率分别为2.8%与3.3%，均无严重并发症，差异无统计学意义。结论经皮肺穿刺前行CEUS检查可对病灶内部结构进行有效评估以及筛选适应证，并可显著提高病理诊断正确率，在经皮肺穿刺活检中具有重要指导价值。
목적：탐토초성조영（contrast enhanced ultrasound，CEUS）재경피폐천자활검적림상응용개치。방법132례폐주점위적환자진행초성인도하경피폐천자활검。기중72례환자천자전진행CEUS검사，위조영조；지전60례미진행CEUS검사，위대조조。비교량조초성도상특점，천자활검차수，병리진단준학솔이급병발증등방면적차이，분석CEUS대제고경피폐천자활검성공솔적응용개치。결과조영조폐주병조내부배사적현시솔위44.4%（32/72），고우대조조적6.7%（4/60），차이유통계학의의（P <0.01）。재조영조중，12.5%（9/72례）현시병조반국부불장폐조직，CEUS가청초현시위우불장폐조직내적병조，대조조위1.7%（1/60례），량조차이구유통계학의의（P <0.05）。조영조대조병리，진단정학솔위95.8%（69/72），고우대조조적80%（48/60），차이유현저통계학의의（P<0.01）。량조천자차수분별위（2.4±0.6）차화（2.6±0.6）차，차이무통계학의의。병발증정황비교，량조발생솔분별위2.8%여3.3%，균무엄중병발증，차이무통계학의의。결론경피폐천자전행CEUS검사가대병조내부결구진행유효평고이급사선괄응증，병가현저제고병리진단정학솔，재경피폐천자활검중구유중요지도개치。
Objective To investigate the clinical application of contrast enhanced ultrasonography (CEUS) in performing percutaneous biopsy for peripheral lung lesions. Methods A total of 132 patients with peripheral lung lesions underwent ultrasonography-guided percutaneous biopsy. Of the 132 patients, 72 received CEUS examinations before biopsy (CEUS group), and 60 received simple biopsy with no CEUS examination (control group). The ultrasonography imaging characteristics, the times of puncture biopsy, the diagnostic accuracy rate and the incidence of complications were recorded , and the results were compared between the two groups. The clinical value of CEUS in improving the success rate of percutaneous biopsy for peripheral pulmonary lesions was analyzed. Results Necrosis(areas of echoless) was demonstrated in 44.4%of the patients (32/72) in CEUS group, while it was displayed in only 6.7% of the patients (4/60) in the control group. The demonstration rate of necrosis in CEUS group were statistically higher than that in the control group (P <0.01). In CEUS group coexisting local pulmonary atelectasis was found in 12.5%of the patients (9/72), and the pulmonary lesion within the atelectasis could be clearly displayed. In the control group, local pulmonary atelectasis was demonstrated only in 1.7% of patients (1/60), the difference between the two groups was statistically significant (P<0.05). The diagnostic accuracy rate of CEUS group and the control group was 95.8% (69/72) and 80% (48/60) respectively, the difference was significant (P<0.01). The average number of punctures in CEUS group and the control group was (2.4 ± 0.6) and (2.6 ± 0.6) times respectively, the difference was not significant. The incidence of complications in CEUS group and the control group was 2.8% and 3.3%respectively, the difference was not significant. No severe complications occurred in both groups. Conclusion CEUS examination that is carried out before percutaneous pulmonary biopsy can effectively demonstrate the inner structure of the lesion, thus the diagnosis can be correctly made. Therefore, CEUS is of great value in guiding percutaneous pulmonary biopsy.