超聲造影引導(dǎo)下經(jīng)皮肺外周型病變穿刺活檢的探討

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1、超聲造影引導(dǎo)下經(jīng)皮肺外周型病變穿刺活檢的探討中南大學(xué)湘雅二醫(yī)院超聲科湖南長(zhǎng)沙410011【摘要】目的：探討超聲造影引導(dǎo)下肺外周型病變經(jīng)皮穿刺活檢病理診斷陽(yáng)性率的成功率以及影響因素。方法：回顧性研究82例肺外周型病變患者的穿刺病理結(jié)果，將其分為造影組(30例)和非造影組(52例)，比較兩組患者超聲引導(dǎo)下穿刺活檢的成功率，并對(duì)其影響因素進(jìn)行分析。結(jié)果：經(jīng)皮肺外周型病變82例，二維超聲引導(dǎo)下穿刺病理診斷陽(yáng)性率為86.5%(45/52),超聲造影引導(dǎo)下穿刺病理診斷陽(yáng)性率為96.7%(29/30)；兩組病灶的平均前后徑分別為：造影組(3.35±0.14)cm和非造影組(2.43&plus

2、mn;0.26)cm,兩者比較差異有統(tǒng)計(jì)學(xué)意義(p=0.012)o非造影組病灶前后徑為1.0?2.0cm、2.1?3.0cm、3.1?5.0cm和大于5.0cm的病理診斷陽(yáng)性率分別為：78.5%、88.9%、85.7%和85.7%。造影組病灶前后徑為1.0?2.0cm>2.1?3.0cm、3.1?5.0cm和大于5.0cm的病理診斷陽(yáng)性率分別為：100%、100%、90%和100%。結(jié)論：超聲可視的病灶大小是影響超聲引導(dǎo)下經(jīng)皮肺外周型病變穿刺活檢病理診斷陽(yáng)性率的重要因素，超聲造影引導(dǎo)下穿刺活檢可避開壞死組織，增加活檢的成功率?！娟P(guān)鍵詞】超聲造影；穿刺活檢；肺外周型病變AbstractObje

3、ctive：ToanalysisandSummarizeclinicalexperienceinContrastenhancedultrasound-guidedpercutaneouspuncturebiopsyofperipheralpulmonarylesions.Methods：Retrospectiveanalysisof82patientswithperipheralpulmonarylesionswhounderwentultrasound—guidedpercutaneousIungbiopsy,WeclassifiedthecasesintotwogroupContrast

4、enhancedultrasoundgroup(30cases)andNoncontrastenhaneedultrasoundgroup(52cases)toevaluatethefactorsaffectingPositiverateofpathologicaldiagnosisInultrasound-guidedpercutaneouspuncturebiopsyofthelung.Rsults：ThepositiverateofpathologicaldiagnosisWas86.5%(45/52)inNoncontrastenhancedultrasoundgroup,96.7%

5、(29/30)inContrastenhancedultrasoundgroup.Lesionsizewasasignificantfactorcontributingtopositiverateofpathologicaldiagnosis(p=0.012).MeanAnteroposteriordiameteroflesions(±SD)inthetwogroupswere3.35±0.14cm(Contrastenhaneedultrasoundgroup)and2.43±0.26cm(Noncontrastenhaneedultrasound

6、group).Forlesions1.0-2.0cm>2.1-3.0cm>3.1-5.0cmand>5.0cminanteroposteriordiameter,thepositiverateofpathologicaldiagnosiswas78.5%、88.9%.92.3%and85.7%inNoncontrastenhancedultrasoundgroup,andwas100%、100%、100%、90%和100%incontrastenhancedultrasoundgroup.Conclusion：Lesionsizewasadeterminingfactorinposit

7、iverateofpathologicaldiagnosis.Thepositiverateofpathologicaldiagnosisdecreasedinproportiontothedecreaseinthelesionanteroposteriordiameter.However,puncturebiopsyguidedbycontrast-enhancedultrasoundcanincrease