Chen Wuxi, Tang Qing, Liang Guosheng, He Liantu, Zhang Shiyu, Tang Jiaxin, Liao Haixing, Zhang Yuxin
Department of Ultrasound, First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Rd, Guangzhou 510120, Guangdong Province, China.
Department of Ultrasound, First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Rd, Guangzhou 510120, Guangdong Province, China; The State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong 510120, China.
Acad Radiol. 2025 Apr;32(4):2272-2280. doi: 10.1016/j.acra.2024.09.033. Epub 2024 Oct 26.
To investigate the diagnostic value of perfluorobutane-enhanced ultrasound (US) examinations for differentiating benign from malignant subpleural lung lesions.
This single-center, retrospective study enrolled consecutive patients with subpleural lung lesions between January 2022 and March 2023. The cause of the lung lesions was confirmed by biopsy and follow-up examinations. The lesions were continuously evaluated using perfluorobutane-enhanced US for 0-180 s, and washout (WT) was observed after 3, 5, and 10 min. Univariate and multivariate analyses were used to identify significant US features, which were evaluated for their diagnostic performance. The diagnostic performance of combining several features for predicting malignant lung lesions was also assessed by multivariate logistic regression analysis.
Seventy cases were included (17 benign lesions [13 men, 4 women; mean age: 57.5 ± 12.2 years] and 53 malignant lesions [41 men, 12 women; mean age: 63.3 ± 11.6 years]). Peak intensity (PI), arrival time (AT), and WT after 10 min significantly differed between malignant and benign lesions. The sensitivity and accuracy were significantly higher for 10-minute WT than for AT (both p < 0.05). The area under the curve of the combined diagnostic evaluation with AT, PI, and 10-minute WT was 0.897 (95% [CI]: 0.806-0.988), which was significantly higher than that of AT or PI alone.
Perfluorobutane-enhanced US can differentiate benign from malignant lung lesions, and combining AT, PI, and 10-minute WT for diagnostic purposes performed better than a single feature.
探讨全氟丁烷增强超声（US）检查对鉴别胸膜下肺良性与恶性病变的诊断价值。
本单中心回顾性研究纳入了2022年1月至2023年3月期间连续的胸膜下肺病变患者。通过活检和随访检查确定肺部病变的病因。使用全氟丁烷增强超声对病变进行0至180秒的连续评估，并在3、5和10分钟后观察洗脱（WT）情况。采用单因素和多因素分析来确定显著的超声特征，并评估其诊断性能。还通过多因素逻辑回归分析评估了结合多种特征预测恶性肺病变的诊断性能。
共纳入70例患者（17例良性病变[男性13例，女性4例；平均年龄：57.5±12.2岁]和53例恶性病变[男性41例，女性12例；平均年龄：63.3±11.6岁]）。恶性和良性病变之间的峰值强度（PI）、到达时间（AT）和10分钟后的WT有显著差异。10分钟WT的敏感性和准确性显著高于AT（均p<0.05）。AT、PI和10分钟WT联合诊断评估的曲线下面积为0.897（95%[CI]：0.806 - 0.988），显著高于单独的AT或PI。
全氟丁烷增强超声能够鉴别肺良性与恶性病变，将AT、PI和10分钟WT结合用于诊断比单一特征表现更好。
