Clinical Value Of Contrast-enhanced Ultrasound In Peripheral Pulmonary Disease

Objective:To investigate the clinical application value of contrast-enhanced ultrasound in differential diagnosis of peripheral pulmonary disease and guided puncture biopsy.Methods:The clinical data of 61 patients who underwent ultrasound-guided puncture biopsy after chest CT diagnosis of peripheral pulmonary disease in our hospital from September 2020 to September 2021 were collected,and they were randomly divided into CEUS group(28 cases)and conventional ultrasound group(33 cases).The distribution characteristics of contrast agent perfusion were observed in the CEUS group,and the arrival time(AT),time to peak(TTP)and peak intensity(PI)of contrast agent were recorded.The clinical application value of the above contrast-enhanced ultrasound parameters in the differential diagnosis of benign and malignant peripheral pulmonary disease was statistically analyzed,and the sampling accuracy and complication rate of puncture for peripheral pulmonary disease were analyzed and compared between the two groups.Results:1.In the CEUS group,there were 28 cases,27 cases had definite puncture pathological results and 1 case was undetermined,including 19 cases of malignant lesions and 8 cases of benign lesions.In benign lesions,homogeneous enhancement was observed in 6 cases,and 2 cases showed uneven enhancement with no enhancement area.The rate of non-enhancement area in benign lesions was 25%(2/8).Among the 19patients with malignant lesions,5 cases had uniform enhancement and 14 cases had uneven enhancement with no enhancement area.The display rate of malignant lesions without enhancement area was 74%(14/19).Fisher’s exact counting method was used for comparison,P=0.033,malignant lesions were more heterogeneous enhancement with no enhancement area than benign lesions.The results were statistically significant.2.By non-parametric test,AT,L-AT and tAT were in line with normal distribution using two independent samples T test;PI and TTP were in skewness distribution using Mann-Whitney U test.The results showed that in the CEUS group,the average AT was9.07±1.04s in benign lesions and 12.47±2.63s in malignant lesions,P=0.034<0.05.TAT was 1.56±1.37s in benign group and 4.67±2.67s in malignant group,P=0.000<0.05.In benign and malignant lesions,the differences of AT and tAT were statistically significant(P<0.05),and the differences of tAT were more significant,while PI and TTP had no statistical significance(P>0.05).3.In this study,all the 58 lesions had clear pathological results.The sampling accuracy of the conventional ultrasound group was 93.9%(31/33),and that of the CEUS group was 96.4%(27/28).In the<5cm group,the lesion sampling accuracy was 100%(15/15)in the conventional ultrasound group and 100%(12/12)in the CEUS group.In the≥5cm group,the sampling accuracy was 87.5%(14/16)in the conventional ultrasound group and 93.3%(14/15)in the CEUS group.In the≥5cm group,the sampling accuracy of CEUS group was slightly higher than that of conventional ultrasound group,and there was no significant statistical significance after X~2test(P>0.05).4.In terms of puncture complications in this study,the total incidence of puncture complications was about 8.2%(5/61),and all cases were improved after observation without special treatment.In the conventional ultrasound group,the incidence of postoperative hemoptysis was 3%(1/33),the incidence of asymptomatic pneumothorax was about 6%(2/33)and the incidence of complications was about 9%(3/33).In the CEUS group,the postoperative incidence of hemoptysis was 7%(2/28),the incidence of pneumothorax was 0(0/28),and the incidence of complications was about 7%(2/28).The incidence of complications in the CEUS group was slightly lower than that in the conventional ultrasound group,and the difference was not statistically significant by x~2test(P>0.05).Conclusions:1.In contrast-enhanced ultrasound,malignant lesions are mostly characterized by uneven enhancement with no enhancement area.2.AT and tAT in the quantitative parameters of contrast-enhanced ultrasound have certain value in differential diagnosis of peripheral pulmonary disease.3.Contrast-enhanced ultrasound has certain value in guiding percutaneous lung puncture.