超声造影引导下经皮肺外周型病变穿刺活检的探讨.doc

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1、超声造影引导下经皮肺外周型病变穿刺活检的探讨中南大学湘雅二医院超声科湖南长沙410011【摘要】目的：探讨超声造影引导下肺外周型病变经皮穿刺活检病理诊断阳性率的成功率以及影响因素。方法：回顾性研究82例肺外周型病变患者的穿刺病理结果，将其分为造影组(30例)和非造影组(52例)，比较两组患者超声引导下穿刺活检的成功率，并对其影响因素进行分析。结果：经皮肺外周型病变82例，二维超声引导下穿刺病理诊断阳性率为86.5%(45/52),超声造影引导下穿刺病理诊断阳性率为96.7%(29/30)；两组病灶的平均前后径分别为：造影组(3.35±0

2、.14)cm和非造影组(2.43±0.26)cm,两者比较差异有统计学意义(p=0.012)o非造影组病灶前后径为1.0〜2.0cm、2.1〜3.0cm、3.1〜5.0cm和大于5.0cm的病理诊断阳性率分别为：78.5%、88.9%、85.7%和85.7%。造影组病灶前后径为1.0〜2.0cm、2.1〜3.0cm、3.1~5.0cm和大于5.0cm的病理诊断阳性率分别为：100%、100%>90%和100%o结论：超声可视的病灶大小是影响超声引导下经皮肺外周型病变穿刺活检病理诊断阳性率的重要因素，超声造影引导下穿刺活检可避开坏死组织，

3、增加活检的成功率。【关键词】超声造影；穿刺活检；肺外周型病变AbstractObjective：ToanalysisandSummarizeclinicalexperienceinContrastenhaneedultrasound-guidedpercutaneouspuncturebiopsyofperipheralpulmonarylesions.Methods：Retrospectiveanalysisof82patientswithperipheralpulmonarylesionswhounderwentultrasound—guided

4、percutaneonslungbiopsy，WeclassifiedthecasesintotwogroupContrastenhancedultrasoundgroup(30cases)andNoncontrastenhaneedultrasoundgroup(52cases)toevaluatethefactorsaffectingPositiverateofpathologicaldiagnosisInultrasound-guidedpercutaneouspuncturebiopsyofthelung.Rsults：Thepositive

5、rateofpathologicaldiagnosisWas86.5%(45/52)inNoncontrastenhancedultrasoundgroup,96.7%(29/30)intopositiverateofpathologicaldiagnosis(p=0.012).MeanAnteroposteriordiameteroflesions(±SD)inthetwogroupswere3.35±0.14cm(Contrastenhancedultrasoundgroup)and2.43±0・26cm

6、(Noncontrastenhancedultrasoundgroup).Forlesions1.0-2.Ocm>2.1-3.0cm>3.1-5.0cmand>5.0cminanteroposteriordiameter,thepositiverateofpathologicaldiagnosiswas78.5%、88.9%、92.3%and85.7%inNoncontrastenhaneedultrasoundgroup,andwas100%>100%>100%n90%和100%incontrastenhancedultrasoundgrou

7、p.Conclusion：Lesionsizewasadeterminingfactorinpositiverateofpathologicaldiagnosis.Thepositiverateofpathologicaldiagnosisdecreasedinproportiontothedecreaseinthelesionanteroposteriordiameter.However,puncturebiopsyguidedbycontrast-enhancedultrasoundcanincreasethesuccessrateofpunct

8、urebiopsypathologicaldiagnosis.KeywordsContrastenhance