常规超声和超声造影在肝脏良恶性局灶性病变鉴别诊断中的价值对比

目的探讨常规超声和超声造影在肝脏良恶性局灶性病变鉴别诊断中的价值对比。方法回顾性分析常规超声和超声造影检查的230例肝脏良恶性局灶性病变患者共246个病灶的临床资料,比较两种检查方法鉴别诊断肝脏良恶性局灶性病变的效能。结果在246个病灶中,常规超声诊断得出肝脏局灶性病变良性结果53个,肝脏局灶性病变恶性结果136个,共准确诊断189个;超声造影诊断得出肝脏局灶性病变良性结果88个,肝脏局灶性病变恶性结果144个,共准确诊断232个。常规超声和超声造影对肝脏局灶性病变良恶性诊断的敏感度(91.3%,96.6%)、特异度(54.6%,90.7%)、阳性预测值(75.6%,94.1%)、阴性预测值(80.3%,94.6%)及准确性(76.8%,94.3%),除敏感性外,其余指标差异均有统计学意义(均P0.05)。结论在肝脏良恶性局灶性病变鉴别诊断中,超声造影的出现和发展为肝脏良恶性局灶性病变的鉴别诊断提供了新的途径,与常规超声鉴别诊断相比较,具有更高的诊断效能。     

超声造影在乳腺实性肿块良恶性诊断中的应用价值

女性乳腺疾病的发生率逐年增加,乳腺癌成为了我国女性发病率最高的恶性肿瘤,乳腺良恶性实性肿块的鉴别诊断一直是医学影像学研究的重点难点.超声造影使实性肿瘤中的低速低流量的微小血管得以显示,并进行实时动态评估,从而提高了诊断及鉴别乳腺良恶性肿块的准确率.该文就超声造影在乳腺实性肿块良恶性诊断中的应用价值进行综述.     

The value of contrast enhanced ultrasound (CEUS) in the characterisation of patients with renal masses

Renal masses are frequently incidentally found on ultrasound. Contrast enhanced computed tomography (CECT) is regarded as the method of choice. Contrast enhanced ultrasound (CEUS) has a high impact for characterisation of hepatic lesions. Its use in renal masses has been less comprehensively studied. Two hundred and one patients referred for surgical treatment of a renal mass, 143 patients fulfilling inclusion criteria (histology and reference method). Baseline ultrasound and CEUS with BR1, histology obtained by surgery (89%) or biopsy (11%). Eighty-eight percent of the patients had renal lesions which were malignant and 12% benign lesions. Eighty percent had renal cell carcinoma (RCC). Seven percent of the lesions were cystic. Two patients were upgraded by CEUS from CECT Bosniak II into CEUS Bosniak III resp. IV. CEUS could predict malignancy with a sensitivity, specificity, positive, negative predictive value and accuracy in 97%, 45%, 91%, 75%, and 90%. The correct staging was diagnosed by CEUS (CECT) in 83% (69%). CEUS was superior to CECT in the staging and characterisation of RCC, also in the subgroup of patients with cystic lesions. CEUS can replace CECT e.g. in patients with allergies or contraindications against CECT. Multicentre studies are necessary to confirm the findings.     

超声造影在经皮肺穿刺活检肺周围型病变中的临床研究

目的探讨超声造影（CEUS）在经皮肺活检肺周围型病变中的临床价值。方法对38例肺周围型病变行彩色多普勒超声和CEUS检查,观察其彩色多普勒和声学造影特征,并选择肿块内造影不同增强区域,在超声引导下行经皮肺穿刺活检。结果38例肺周围型病变彩色多普勒与CEUS血流分级比较,乏血供组与富血供组Х^2=28．33,P〈0．001,差异具有统计学意义。38例肺周围型病变中,彩色多普勒超声可显示全部病灶内部血流19例,超声造影均能显示病灶内部血流状态。造影剂分布特征均匀增强型9例,不均匀增强型29例（Fisher检验,P=0．005）。经病理证实,29例为恶性病变,其超声造影均表现为病灶局部高增强改变（100％,29／29）。9例为良性病变,其造影模式表现为较多样化,其中2例病灶呈高增强,5例等增强,2例低／无增强。CEUS引导下在高增强区域穿刺能获得恶性病变准确病理诊断,且无严重穿刺并发症发生。结论超声造影可提高周围型肺癌的活检成功率,降低操作风险,是经皮肺穿刺活检重要的辅助方法。     

超声与钼靶检查对乳腺疾病良恶性诊断的对比分析

目的系统、定量地评价超声及钼靶成像技术对乳腺疾病的诊断准确性及诊断特点,为乳腺疾病选择影像学检查提供有价值的指导。方法分析228例患者237个乳腺结节彩色多普勒超声及钼靶声像学特征,以病理组织结果为金标准,评价多普勒超声、钼靶以及两者联合对乳腺疾病良恶性诊断价值。结果本组病理检查结果良性188例（194个结节）,恶性40例（43个结节）;彩色多普勒超声诊断恶性病变灵敏度为46.5%,特异度为80.4%,正确率为74.2%;X线钼靶诊断乳腺恶性肿瘤的灵敏度为55.8%,特异度为75.2%,正确率为71.7%;两者结合诊断乳腺恶性肿瘤灵敏度为90.6%,特异度为89.6%,正确率为89.8%。结论多普勒超声及钼靶检查对乳腺肿块定性诊断均有较高价值,两者结合可提高鉴别乳腺肿瘤良恶性正确率,在临床诊断及制定治疗方案上有重要的指导价值。     

Endoscopic and histological diagnosis on upper gastrointestinal cancer screening

BACKGROUND/AIMS: Screening endoscopy for upper gastrointestinal cancer has come into wide use in Japan. We aim to clarify the limitation of its endoscopic diagnosis and contribution of histological biopsy on routine endoscopy. METHODOLOGY: For consecutive 1184 patients (696 men and 488 women, average age of 57 years) undergoing routine esophagogastroduodenoscopy, we prospectively evaluated endoscopic diagnosis with regard to grade of malignancy (definitely cancer, E5; probably cancer, E4; dysplasia/adenoma or indeterminate malignant, E3; probably benign, E2; and definitely benign, E1). Histological grade was defined as H5 (cancer), H4 (probably cancer), H3 (dysplasia/ adenoma or indeterminate malignant), H2 (probably benign), and H1 (definitely benign) in 267 patients undergoing endoscopic forceps biopsy. We analyzed the accuracy of endoscopic and histological biopsy diagnosis. RESULTS: Incidence of neoplastic lesions including H3, H4, and H5 was 0% in E1 (0/978), 2% in E2 (3/132), 19% in E3 (6/31), 33% in E4 (3/9), and 100% in E5 lesions (34/34). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of endoscopic diagnosis for these neoplastic lesions were 94%, 97%, 58%, 99%, and 97%, respectively. CONCLUSIONS: Better awareness of its endoscopic features and appropriate endoscopic biopsy is essential in the diagnosis of upper gastrointestinal cancer on screening endoscopy.     

Undetermined focal liver lesions on gray-scale ultrasound in patients with fatty liver: characterization with contrast-enhanced ultrasound

Background and Aim: The purpose of this study was to assess the clinical value and potential impact of contrast‐enhanced ultrasound (CEUS) in the characterization of undetermined focal liver lesions (FLLs) in patients with fatty liver. Methods: Fifty‐two patients (34 men, 18 women) with fatty liver with 67 FLLs (size range, 1–8.6 cm; mean, 4.1 ± 3.1 cm) undetermined at baseline ultrasound (US) underwent contrast‐enhanced US. CEUS examinations were analyzed by two experienced sonologists blinded to the final diagnosis. Readers evaluated by consensus the baseline echogenicity, the dynamic enhancement pattern in comparison with peripheral liver parenchyma. The final diagnosis was based on consensus interpreting of all examinations by another two expert observers with access to histological data. The characterization accuracy, sensitivity, and specificity of CEUS in characterizing the lesion as benign or malignant, and as the correct pathologic type, were analyzed. Results: After CEUS, two hemangiomas, three inflammatory pseudotumors, and one hepatocellular carcinoma were misdiagnosed. The overall characterization accuracy, sensitivity and specificity of CEUS were 91% (61/67), 91.7% (11/12), and 90.9% (50/55), respectively. Forty‐three benign lesions were diagnosed as the correct pathologic type. The portal venous phase and late phase were important in the characterization of the lesions. The characterization accuracy had no relationship with the size of FLLs. Conclusion: CEUS can improve the characterization of undetermined FLLs arising from fatty liver.     

虚拟导航超声造影与常规超声造影检查肝硬化背景小肝癌的诊断价值比较

目的探讨虚拟导航超声造影与常规超声造影检查肝硬化背景小肝癌的诊断效能。方法 45例肝硬化患者经增强CT/MRI检查提示肝内局灶性结节共计68个,全部病灶均经病理检查确诊,其中小肝癌45个,肝硬化结节(非小肝癌)23个。分别行常规超声造影检查及虚拟导航超声造影检查,计算2种方法的灵敏度、特异度及正确率等指标。结果常规超声造影诊断小肝癌的灵敏度、特异度及正确率依次为60.0%、69.5%和63.2%,虚拟导航超声造影依次为86.6%、78.3%和83.8%。虚拟导航超声造影诊断小肝癌的灵敏度、特异度和正确率高于常规超声造影(P均<0.05)。结论虚拟导航超声造影可检出常规超声造影不易检出的肝硬化结节背景下小肝癌,为临床诊断提供有效支持。     

数字乳腺断层摄影在乳腺良恶性结节鉴别中的价值

目的与乳腺超声检查结果对比,评估数字乳腺断层X线摄影(DBT)鉴别乳腺良、恶性结节的效能。 方法回顾性分析2019年1月至2020年6月于南昌大学第二附属医院进行乳腺结节手术的患者资料,分别计算DBT及超声诊断乳腺良恶性结节的灵敏度、特异度及准确度,采用ROC分析评价DBT及超声结果与病理结果的一致性,并对二者进行比较。 结果DBT与超声对乳腺良恶性结节诊断的灵敏度分别为88.46%、75.00%,特异度为91.43%、94.29%,准确度为91.95%、82.76%,AUC为89.0%、81.8%。DBT诊断乳腺结节的准确度、灵敏度及曲线下面积均高于超声检查,特异度略低于超声检查。 结论DBT在乳腺结节良恶性的鉴别中具有较高的诊断效能,有利于乳腺癌的筛查及诊断,其效能不亚于乳腺超声。     

超声造影判定术前直肠癌T分期的临床应用价值

背景准确判定直肠癌T分期状态,对于指导临床治疗有着重要价值.超声具有操作简便,无创等优点,在直肠癌诊治中发挥着重要作用.超声造影(contrast-enhanced ultrasonography,CEUS)可动态反映直肠癌的微循环灌注状态,显示病灶浸润范围,提高病灶边界精确度,有助于准确判定直肠癌的T分期状态.目的探讨运用CEUS判定术前直肠癌T分期的临床应用价值.方法选取在浙江医院行手术切除治疗的66例直肠癌患者作为研究对象.所有患者术前均行经直肠常规超声检查以及CEUS检查,观察并记录病灶的CEUS增强特征及T分期结果,与术后病理结果进行比较分析.结果CEUS判定术前直肠癌T分期的总诊断符合率92.42%(61/66)明显高于常规超声的总诊断符合率72.73%(48/66),差异有统计学意义(P<0.05);CEUS判定直肠癌T2和T3期的诊断符合率明显高于常规超声,差异有统计学意义(P<0.05);两种检查对T1和T4期的诊断符合率比较无明显统计学差异(P>0.05).结论CEUS能实时动态反映直肠癌的微循环灌注状态,能清晰显示病灶浸润范围,从而准确判定术前直肠癌T分期,具有较高临床应用价值.     

超声内镜弹性成像在良恶性胰腺病变鉴别中的应用价值

目的:探讨超声内镜弹性成像(endoscopic ultrasound,EUS)在胰腺占位病变良恶性鉴别中的应用价值.方法:影像学结果并经超声内镜检查确定有胰腺占位性病变的患者入选,对目标病变行超声内镜弹性成像检查,按照弹性成像5分法对组织弹性成像进行评分,将弹性成像评分为12分归为良性,3-5分归为恶性病变.结果:自2009-06/2011-06,共27例符合标准的胰腺占位病变患者入选,其中胰腺癌19例,超声内镜弹性成像评分3分(n=11)、4分(n=5)、5分(n=3),无功能性良性内分泌肿瘤(4分)及低度恶性神经内分泌肿瘤(5分)各1例,炎性病变6例,评分1分(n=1)、2分(n=3)、3分(n=2).超声内镜弹性成像对27例胰腺占位病变良恶性鉴别中24例诊断准确,诊断灵敏度100%,特异度57.14%,阳性预测值86.96%,阴性预测值100%.结论:超声内镜弹性成像对胰腺良恶性病变的鉴别具有较高的准确性,可望为疾病诊断提供新的影像学手段,但其仍为一种影像学手段,具有一定的局限性,并不替代胰腺的细胞病理学检查.     

肝脓肿患者超声造影特点及诊断价值分析

目的 研究肝脓肿患者超声造影(CEUS)检查表现特点及诊断价值。方法 2016年4月～2019年4月我院收治的120例肝脓肿患者,行常规二维超声和CEUS检查,分析其影像学特征,以穿刺治疗结果为金标准,分析CEUS和常规二维超声诊断肝脓肿病灶的一致性。结果 在120例患者中,脓肿炎性期22例,脓肿形成初期42例和脓肿形成期56例;常规二维超声检出107例(89.2%),其中脓肿炎性期和脓肿形成初期影像学表现为不规则或规则病灶,病灶边界不清晰或清晰,病灶内未见液性暗区,可见血流信号,脓肿形成期影像学表现为不规则或规则病灶,病灶边界不清晰或清晰,病灶内见液性暗区,无血流信号;CEUS检出肝脓肿117例(95.0%),其中脓肿炎性期和脓肿形成初期影像学表现为病灶动脉期高增强,门静脉期和延迟期低增强,显示范围较常规超声明显增大,脓肿形成期影像学表现为病灶动脉期高增强,门静脉期和延迟期低增强现象减少,显示范围较常规超声明显增大;CEUS诊断肝脓肿病灶的灵敏度为95.0%,特异度为76.9%,阳性预测值为89.7%,阴性预测值为33.3%,Kappa值为0.88。结论 不同病程的肝脓肿CEUS影像学表现各有特点,其诊断肝脓肿的灵敏度、特异度和准确性均较高,在鉴别诊断有困难时可以考虑应用。     

超声造影鉴别诊断肝脏局灶性病变的价值

目的探讨超声造影对肝脏局灶性病变的临床诊断价值。方法回顾性分析110例肝脏局灶性病变患者的超声造影检查结果,分析造影表现特征,并经手术或穿刺病理结果证实。结果以手术或穿刺病理确诊结果为标准,超声造影检查对良、恶性肝脏局灶性病变的诊断率分别为97.5%、96%,差异无统计学意义(P0.05)。良性病变的增强时间、达峰时间及消退时间均明显晚于恶性病变,差异均具有统计学意义(P0.05)。本组110例肝脏局灶性病变患者超声造影检查诊断出病变114个,表现特征分别为:肝内胆管细胞癌47个,为快进快出特征;肝细胞癌5个,为快进慢出特征;肝转移癌22个,为快进快出特征;肝血管癌20个,为快进快出特征;肝硬化结节7个,为快进快出特征;局灶性脂肪肝8个,为等进等出特征;局灶性结节增生2个,为快进慢出特征;肝脓肿3个,为快进快出特征。结论超声造影对良性和恶性肝脏局灶性病变的鉴别诊断准确率较高,并能清晰反映出不同性质病变的造影增强特征,具有较高的实用价值,值得进一步推广与应用。     

共聚焦激光显微内镜对胃非隆起型病变的诊断价值

目的探讨共聚焦激光显微内镜检查（CLE）对胃非隆起性病变良、恶性的鉴别诊断价值。方法对37例常规内镜发现的胃非隆起型病变患者行CLE检查。静脉注射荧光素钠后对病变区域进行观察,然后进行靶向活检。对CLE或靶向活检病理诊断为恶性病变者进行内镜或手术治疗,术后对整块标本进行病理学检查;对良性患者予规范药物治疗并每隔3个月复查胃镜,直至病变愈合。结果CLE诊断癌性病变11例,良性病变26例。靶向活检病理证实CLE诊断的11例癌变者中10例为癌,1例为良性;26例良性者中1例为癌,余皆为良性。共12例接受切除治疗（3例内镜治疗,9例外科手术）,术后病理学证实与靶向活检病理诊断完全一致。良性者随访中未发现有恶变,经平均3．16（3．58±1．20）个月的内镜随访,病变均愈合。CLE对胃非隆起性病变癌变诊断的灵敏度、特异度和准确度分别为90．9％、96．2％和90．9％,阳性预测值和阴性预测值分别为90．9％和96．2％;CLE与组织学检查的Kappa值为0．871。结论CLE对胃非隆起型病变具有较高的诊断价值,将有望替代活检病理做出实时组织学诊断。     

LI-RADS超声分类诊断肝脏占位性病变准确性分析

目的 探讨应用LI-RADS超声分类方法诊断肝脏占位性病变的准确性。方法 2018年1月～2019年9月我院经病理学检查诊断为肝脏占位性病变患者60例,均接受超声造影检查。按照LI-RADS分类方法,分别以LR-3(方法1)和LR-4a(方法2)作为为截断点,分析两种方法鉴别良恶性病变的效能。结果 在60例肝占位性病变患者中,综合诊断肝囊肿4例,肝血管瘤16例,肝脓肿8例,肝局灶性脂肪变9例,肝局灶性结节性增生9例,肝细胞癌8例,肝转移瘤6例;以病理学检查诊断为金标准,方法1诊断恶性病变22例,良性病变38例。方法 2诊断恶性病变14例,良性病变46例;方法1诊断的灵敏度、特异度和正确率分别为85.7%、78.2%和80.0%,而方法2则分别为78.6%、93.5%(P<0.05)和100.0%(P<0.05)。结论 采用LI-RADS 方法2分辨肝脏占位性病变的性质具有很高的准确性,其临床应用价值值得进一步研究。     

超声造影灌注时相分析在肝硬化背景下对肝脏增生结节的诊断价值

目的 探讨超声造影(CEUS)灌注时相分析在肝硬化背景下对肝脏增生结节的诊断价值.方法 2017年6月～2020年6月我院诊治的肝硬化患者100例,均接受CEUS检查,获得超声造影定量参数,包括造影峰值强度(Peak)、达峰时间(TTP)和平均度越时间(MTT),记录两组局部血容量(RBV)和局部血流量(RBF)水平....     

Value of imprint cytology for ultrasound-guided transthoracic core biopsy.

The aim of this study was to investigate the possible additional diagnostic information provided by imprint cytology when performing ultrasound-guided transthoracic core biopsy and to evaluate whether it could optimise the biopsy procedure. A total of 155 transthoracic core biopsies with touch imprint smears were performed under ultrasound guidance, with 127 malignant and 28 benign lesions. The imprint smears were stained using Riu's method and interpreted by a cytopathologist. These were compared with the histopathology of core biopsy specimens and the final diagnosis of malignant versus benign disease. The overall diagnostic accuracy of imprint cytology was 94% (146 out of 155). Histopathological analysis showed an overall accuracy of 94% (146 out of 155), with a sensitivity of 94% (119 out of 127) and negative predictive value of 79% (27 out of 34). The combination of these two methodologies had an increased overall accuracy and negative predictive value of 98% (152 out of 155) and 90% (28 out of 31), respectively. The results of imprint cytology and histopathology were in agreement in 143 patients (92%). In conclusion, imprint cytology of ultrasound-guided transthoracic core biopsy is a sensitive procedure for diagnosing peripheral thoracic lesions, and it may increase the diagnostic accuracy and cancer negative prediction of biopsy alone. With an on-site approach, imprint cytology may help to assess the adequacy of biopsy specimens and optimise the biopsy procedure.     

Contrast-enhanced ultrasound: Improving the preoperative staging of hepatocellular carcinoma and guiding individual treatment

AIM: To investigate the clinical role of contrast-enhanced ultrasound (CEUS) combined with contrast-enhanced computed tomography (CE-CT) or magnetic resonance imaging to improve the preoperative staging of hepatocellular carcinoma (HCC) and guide surgical decision-making.METHODS: Sixty-nine patients who underwent liver resection for HCC in our center were enrolled prospectively in the study. CEUS and CE-CT/MRI were performed before surgery. Intraoperative ultrasound (IOUS) was carried out after liver mobilization. Lesions depicted by each imaging modality were counted and mapped. To investigate the impact of tumor size on the study, we divided the patients into two groups, the “Smaller group”(S-group, ≤ 5 cm in diameter) and the “Larger-group” (L-group, > 5 cm in diameter). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CE-CT/MRI, CEUS, IOUS, CEUS+CE-CT/MRI and the tumor node metastasis staging of tumors were calculated and compared. Changes in the surgical strategy as a result of CEUS and IOUS were analyzed.RESULTS: One hundred and twenty-seven nodules, comprising 94 HCCs confirmed by histopathology and 33 benign lesions confirmed by histopathology and follow-up, were identified in 69 patients. The overall diagnostic sensitivity rates of CE-CT/MRI, CEUS, IOUS and CEUS+ CE-CT/MRI were 78.7%, 89.4%, 89.4% and 89.4%, respectively. There was a significant difference between CEUS + CE-CT/MRI and CE-CT/MRI (P = 0.046). Combining CEUS with CT or MRI increased, the diagnostic specificity compared with CT/MRI, CEUS and IOUS, and this difference was statistically significant (100%, 72.7%, 97.0%, and 69.7%, P = 0.004, P = 0.002, P = 0.002, respectively). The diagnostic accuracy was significantly higher for CEUS + CT/MRI compared with CT/MRI (92.1% vs 77.2%, P = 0.001). The TNM staging of tumors based on CEUS + CE-CT/MRI approximated to the final pathological TNM staging (P = 0.977). There was a significant difference in the accuracy of TNM staging when comparing CEUS + CE-CT/MRI with CE-CT/MRI (P = 0.002). Before surgery, strategies were changed in 15.9% (11/69) of patients as a result of CEUS. Finally, only 5.7% (4/69) of surgical strategies were changed because of IOUS findings. In the S-group, CEUS revealed 12 false positive lesions, including seven false positive lesions that were diagnosed by preoperative imaging examinations and five by IOUS. In contrast, in the L-group, IUOS revealed eight new malignant lesions; six of these lesions were true HCCs that were also identified by preoperative CEUS.CONCLUSION: CEUS combined with CT or MRI improves the accuracy of preoperative staging for hepatocellular carcinoma and may help to guide individualized treatment for patients with HCC. CEUS may better identify non-malignant lesions in patients with small tumors and discover new malignant lesions in patients with large tumors.     

Small hepatic nodules (< or =2 cm) in cirrhosis patients: characterization with contrast-enhanced ultrasonography.

AIM: We evaluated the efficacy of contrast-enhanced ultrasonography (CEUS) for the characterization of small hepatic nodules (< or =2 cm) in cirrhosis patients. PATIENTS AND METHODS: Thirty cirrhosis patients with 30 hepatic nodules (1-2 cm) were enrolled in this study. Eighteen hepatic nodules were hepatocellular carcinomas (HCC) and 12 were benign lesions. CEUS was performed using microbubble contrast (Levovist). With surrounding hepatic parenchyma as a reference, two characteristics of hepatic nodules, including arterial phase enhancement (AE) and the absence of delayed phase enhancement (ADE), were evaluated as criteria for the diagnosis of HCC. A radiologist independently reviewed the dynamic computed tomographies (CT) of 26 hepatic nodules. RESULTS: CEUS showed AE in 15 nodules (13 HCC and two benign) and ADE in 17 lesions (14 HCC and three benign). For HCC, the coincidental AE of both CEUS and dynamic CT was 40%. Using both AE and ADE for HCC diagnosis, the sensitivity, specificity, accuracy, positive predictive value and negative predictive values were 55.6%, 91.7%, 70%, 90.9% and 57.9%, respectively. When using either AE or ADE for HCC diagnosis, the same parameters were 94.4%, 66.7%, 83.3%, 81% and 88.9%, respectively. One benign hepatic nodule with both AE and ADE was diagnosed as HCC 29 months after the CEUS study. CONCLUSIONS: A combination of characteristics of AE and ADE as determined by CEUS was highly specific for small HCCs in cirrhosis patients. Concurrent delayed phase imaging is useful in the diagnosis of small hypovascular HCCs.     

Scoring model of convex probe endobronchial ultrasound multimodal imaging in differentiating benign and malignant lung lesions

BackgroundConvex probe endobronchial ultrasound images can reflect the morphology, blood flow status and stiffness of the lesions. Endobronchial ultrasound multimodal imaging has great value for the diagnosis of intrathoracic lymph nodes. This study aimed to analyze the application of endobronchial ultrasound multimodal imaging on lung lesions.MethodsPatients undergoing endobronchial ultrasound-guided transbronchial needle aspiration in Shanghai Chest Hospital from July 2018 to December 2019 were retrospectively enrolled. Nine grayscale features (long and short axes, margin, shape, lobulation sign, echogenicity, necrosis, liquefaction, calcification, and air-bronchogram), blood flow volume and elastography five-score method were analyzed to explore the best diagnostic method. The gold standard for diagnosing lesions depends on the histological and cytopathological findings of endobronchial ultrasound-guided transbronchial needle aspiration, transthoracic biopsy, resected sample of lesions, microbiological examination or clinical follow-up of at least 6 months.ResultsEndobronchial ultrasound multimodal imaging of 97 malignant lung lesions and 19 benign lung lesions from 116 patients were analyzed. There were statistically significant differences in distinct margin, presence of lobulation sign, presence of necrosis, and elastography grading score 4–5 between malignant and benign lung lesions, among which presence of lobulation sign and elastography grading score 4–5 were independent predictors. A diagnostic scoring model was then constructed based on the above four features, and when two or more features were present, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy for malignant lung lesions prediction were 92.78%, 57.89%, 91.84%, 61.11% and 87.07%, respectively.ConclusionsThe combination of endobronchial ultrasound grayscale and elastography has potential value for malignant and benign lung lesions differentiation. The diagnostic scoring model established in this study needs further validation to guide the malignant and benign diagnosis of lung lesions.