Second Department of Pulmonary and Critical Care Medicine.
Department of Function.
Medicine (Baltimore). 2022 Jul 22;101(29):e29605. doi: 10.1097/MD.0000000000029605.
Peripheral pulmonary lesions are encountered frequently in clinical practice. Accurate diagnosis of these lesions is of great importance for clinicians. Ultrasound-guided lung tissue puncture is a reliable method for diagnosing these lesions.
To investigate the application value of contrast-enhanced ultrasound (CEUS) combined with rapid on-site evaluation (ROSE) in the diagnosis of peripheral pulmonary focal lesions.
Eighty patients enrolled from July 2020 to June 2021 were divided into two groups: a conventional ultrasound group and a CEUS group. Both groups underwent diagnostic procedures guided by ROSE to improve the success rate of puncture sampling. The success rates and complications in both groups were compared. The results for lesion enhancement, time taken for the contrast agent to reach the lesions (AT) and lung tissues (L-AT), and the difference between these times (∆AT) were compared in the CEUS group.
The success rate of biopsy in the CEUS group was 97.62%, which was significantly higher than that in the conventional ultrasound group (84%; P < .05). Puncture complications did not occur in the CEUS group and occurred in 5.26% of the cases in the conventional ultrasound group, but the difference was not statistically significant (P > .05). A comparison of enhancement of benign lesions and malignant lesions in the CEUS group showed a statistically significant difference (P < .05). The difference between the AT and ∆AT of benign and malignant lesions was statistically significant (P <.05). The optimal threshold of ∆AT was 2.05 s.
CEUS combined with ROSE is a very important approach for biopsy in the diagnosis of peripheral pulmonary focal lesions. CEUS has definite clinical value in the diagnosis of benign and malignant lung lesions.
外周肺部病变在临床实践中经常遇到。准确诊断这些病变对临床医生非常重要。超声引导下肺组织穿刺是诊断这些病变的可靠方法。
探讨超声造影（CEUS）联合快速现场评估（ROSE）在外周肺部局灶性病变诊断中的应用价值。
将 2020 年 7 月至 2021 年 6 月间的 80 例患者分为常规超声组和 CEUS 组，两组均采用 ROSE 引导下的诊断程序以提高穿刺采样成功率，比较两组的成功率和并发症。比较 CEUS 组病变增强、造影剂到达病变（AT）和肺组织（L-AT）的时间以及两者之间的差异（∆AT）。
CEUS 组活检成功率为 97.62%，明显高于常规超声组（84%；P<.05）。CEUS 组未发生穿刺并发症，而常规超声组有 5.26%的病例发生穿刺并发症，但差异无统计学意义（P>.05）。CEUS 组对良性和恶性病变的增强情况进行比较，差异有统计学意义（P<.05）。良性和恶性病变的 AT 和 ∆AT 差异有统计学意义（P<.05）。∆AT 的最佳阈值为 2.05 s。
CEUS 联合 ROSE 是诊断外周肺部局灶性病变活检的重要方法。CEUS 在诊断良恶性肺部病变方面具有明确的临床价值。
