超声造影定量参数对肺部良恶性病变鉴别诊断的研究

目的:探讨超声造影定量参数对于肺部良恶性病变鉴别诊断的应用价值。方法:将经穿刺活检病理及临床确诊的51例肺部病变分为良性组及恶性组,对超声造影时间-强度曲线(Time-intensity curve,TIC)各定量参数及造影剂到达肺部病变及邻近肺组织的时间差进行定量分析。结果:①超声造影TIC曲线定量参数中始增时间(Contrast agent arrive time,AT)良性组小于恶性组,两组间比较差异有统计学意义(P<0.05),超声造影TIC曲线定量参数中达峰时间(Time to peak,TTP)、上升时间(Rise time,RT)、峰值强度(Maximum intensity,IMAX)、上升支斜率(Rising slope,RS)在两组间比较均无统计学意义(P>0.05)。②在恶性组中分出鳞癌组与腺癌组,超声造影TIC曲线各定量参数在两组间比较均无统计学意义(P>0.05)。③造影剂到达肺部病变及邻近肺组织的时间差良性组小于恶性组,两组间比较差异有统计学意义(P<0.05),该时间差最佳截点值为2.5 s。结论:①超声造影TIC曲线定量参数中AT在肺部病变良恶性的鉴别诊断中有一定的临床应用价值。②造影剂到达肺部病变及邻近肺组织的时间差对肺部良恶性病变有一定的鉴别诊断价值,该时间差<2.5 s提示病变趋于良性,该时间差>2.5s提示病变趋于恶性。

Study on differential diagnosis of benign and malignant lung lesions with quantitative parameters of contrast-enhanced ultrasonography

Objective: To evaluate the value of quantitative parameters of contrast-enhanced ultrasonography in differential diagnosis of benign and malignant lung lesions. Methods: Fifty-one cases of lung lesions diagnosed by puncture pathology were divided into benign group and malignant group, the quantitative parameters of contrast-enhanced ultrasonography time intensity curve(TIC) and the time difference of contrast agent to lung lesions and adjacent lung tissues were quantitatively ana-lyzed. Results: ①In the quantitative parameters of TIC, the contrast agent arrive time(AT) in the benign group was less than that in the malignant group, and the difference was statistically significant between the two groups(P<0.05). There was no significant difference in the time to peak(TTP), the rise time(RT), the maximum intensity(IMAX) and the rising slope(RS) between the two groups(P >0.05). ② Squamous cell carcinoma group and adenocarcinoma group were divided from malignant group.There was no significant difference in quantitative parameters of TIC between the two groups(P>0.05). ③The time difference of contrast agent to lung lesions and adjacent lung tissues in the benign group was less than that in the malignant group, and the difference was statistically significant between the two groups(P<0.05). The optimal cut-off point of the time difference was2.5 s. Conclusion: ①The quantitative parameters of TIC have definite clinical value in the differential diagnosis of benign and malignant lung lesions. ②The time difference of contrast agent to lung lesions and adjacent lung tissues has certain value in the differential diagnosis of benign and malignant lung lesions. The time difference<2.5 s indicates that the lesions tend to be benign, and the time difference>2.5 s indicates that the lesions tend to be malignant.