Clinical Application Progress Of Ultrasound In Peripheral Lung Cancer

Background:Lung cancer is a fatal killer that threatens human health.Especially in China,morbidity and mortality are the highest among malignant tumors,and the incidence rate is increasing year by year,and there is a tendency to be younger.Therefore,accurate,efficient,and convenient diagnosis is very important for the early detection of lung cancer and the determination of the pathological type,so that a reasonable treatment plan can be formulated later to improve the survival rate of lung cancer patients.However,due to the presence of lung gas,the application of ultrasound in the diagnosis and treatment of lung cancer has been limited.However,the location of peripheral lung cancer is superficial,close to and even close to the chest wall,which provides feasibility for ultrasound examination.In recent years,with the continuous development of ultrasound technology,the role of conventional ultrasound and ultrasound technology in peripheral lung cancer has gradually gained recognition.Objectives:1.Through the review of related literature,we summarize the conventional ultrasound findings of peripheral lung cancer and the differential diagnosis of ultrasound with other peripheral lung diseases,and summarize the application value of various new ultrasound technologies in peripheral lung cancer to improve the preoperative ultrasound diagnosis rate of peripheral lung cancer.2.Through the review of related literature and the recent cases of lung biopsy under ultrasound guidance in our hospital,the success rate and complications of lung biopsy guided by different ultrasound techniques are discussed.Methods:A retrospective analysis of relevant literature at home and abroad over the past 20 years,including 60 articles from 2010 to 2018,21 articles from 2000 to 2009,and 4 articles from 1990 to 1999;English literature 26 Articles,59Chinese articles.A total of 15 patients underwent ultrasound-guided lung biopsy in our hospital for a total of 15 cases were collected.Eleven patients underwent routine ultrasound-guided puncture,4 patients underwent SMI-guided puncture,and the data were briefly analyzed.Results:(1)Routine Ultrasonographic Imaging of Peripheral Lung Cancer:Cranial nodules with moderate or hypoechoic contours,clear outlines,but irregular edges,often infringement of pleural continuation of pleural continuum,and its blood flow signal distribution is relatively small and relatively messy,and the blood flow spectrum is mostly low speed and low resistance type.(2)Contrast-enhanced ultrasonography of peripheral lung cancer showed a pattern of slow progression and rapid regression.Peak intensity of angiography was higher than that of benign lesions(>15.7 dB).(3)The ratio of strain rate of ultrasonic elastography and transverse shear wave velocity were significantly different from benign lesions in peripheral lung cancer.(4)The diagnostic specificity and sensitivity of ultrasonic bronchoscope for peripheral lung cancer can reach 93%?100%and 91.6%?96.8%,respectively.(5)The success rate of lung biopsy can be as high as 91.6%?96.8%by selecting appropriate ultrasound guidance techniques,methods,and probes.The complications mainly include pneumothorax and hemorrhage,and the incidence rate is about 1.1%?17.2%,And more at about 5%.(6)The pathological results of 15 cases of lung biopsy in our hospital showed 7 cases of malignant lesions,4 cases of benign lesions and 4 cases of non-definitive nature.There were 11 cases in the routine group and 7 cases in success.The success rate of needle biopsy was 63.6%(7/11).Four patients in the SMI group were successful.The success rate of needle biopsy was 100%(4/4).The total success rate of puncture was 73.3%(11/15).Of the 7 cases with malignant lesions,3 cases is squamous cell carcinoma,3 cases is adenocarcinoma,and cases is large cell lung cancer.Only one case of pneumothorax complication occurred in the routine group,and SMI group without any complicationsConclusion:The value of ultrasound in peripheral lung cancer is worthy of recognition:(1)Routine ultrasound and various new ultrasound technologies complement each other and complement each other.(2)Two-dimensional ultrasound can accurately determine the shape,size,boundary,internal echo and the relationship with the pleura of the lesion,and initially determine the benign and malignant lesions.(3)Doppler ultrasound and contrast-enhanced ultrasound can show the blood perfusion of the lesions,blood flow spectrum information,etc.,to further judge the benign and malignant lesions.(4)Elasticity imaging is currently used less frequently in peripheral lung cancer,but its feasibility has been affirmed.(5)Ultrasonic bronchoscope as an intracavity ultrasound can penetrate deep inside the bronchus,reduce the distance between the lesion and the lesion,and expand the scope of application.(6)Ultrasound-guided lung biopsy is now widely used clinically.This guidance method is economical,convenient,and safe.The success rate is high and the complication rate is low.As an auxiliary examination,ultrasound can provide a large amount of effective information for the diagnosis and differential diagnosis of peripheral lung cancer,and assist the clinician in making accurate judgments about the disease.