The Application Value Of Contrast-enhanced Ultrasound And Contrast-enhanced Ultrasound Microvascular Imaging In Percutaneous Biopsy Of Thoracic Lesions

Objective:The purpose of this study was to analysis the perfusion pattern of thoracic lesions with contrast-enhanced ultrasound microvascular imaging,then investigate the application value of and contrast-enhanced ultrasound microvascular imaging in percutaneous biopsy guided by ultrasonography of thoracic lesions.Methods: Randomly divided 120 patients with underwent thoracic lesions underwent percutaneous biopsy guided by ultrasonography in our hospital into CEUS-group(54 cases)and US-group(66 cases),In the CEUS-group,after the routine ultrasound examination,SonoVue contrast agent was applied to start the ultrasound imaging software(CHI).After 2 minutes of recording,the ultrasound imaging microangiography software was started.Choosing the CEUS-enhanced and the MVI vascular-enriched area as the sampled site of biopsy.In the US-group,Choosing the section can be used to show the location of the blood supply or marginal area in the largest section for the biopsy only based on conventional two-dimensional and color Doppler ultrasonographyexaminations.The puncture time,success rate,positive rate,pathological tissue necrosis rate and incidence of complications were compared between the two groups.Results:1.In the CEUS-group,conventional ultrasound and CEUS showed 4 cases(4/54)and 26 cases(26/54)of lesions with necrosis area,and the difference in the detection abilities of necrotic areas within the lesions was statistically significant(P<0.05).2.In the CEUS-group,CDFI and MVI showed grade 0 blood flow in 15 cases and 0 cases respectively,grade I blood flow in 25 cases and 2 cases respectively,grade II blood flow in 12 cases and 22 cases,and grade III blood flow in 2 cases and 30 cases.There were statistically significant difference in the blood flow signals between the two groups(P<0.05).3.In the CEUS-group,the linear,dendritic and residual root types of MVI in benign lesions accounted for 63.64%(7/11),27.27%(3/11),and 9.09%(1/11),respectively;The MVI vascular skeletons of malignant lesions account for11.63%(5/43),6.98%(3/43)and 81.40%(35/43)of the MVI vascular skeletons,respectively.There were statistically significant difference in the MVI vascular framework between benign and malignant lesions(P<0.05).4.There was no significant difference in CEUS intensity between benign and malignant lesions in the CEUS-group(P>0.05).There were significant difference in CEUS enhancement pattern and the start time of the infusion between benign and malignant lesions(P<0.05).5.In the time-intensity curve quantitative analysis of the CEUS-group,the mean transit time between benign and malignant lesions was statistically significance(P<0.05),there were no significance in the peak intensity,time topeak,slope,area under the curve,area wash in and area wash out(P>0.05).6.There were no significant difference in the number of punctures,in the US-group and the CEUS-group(P>0.05),and the success rate of sampling,the rate of positive collection,the rate of pathological tissue necrosis,and the incidence of postoperative complications were statistically significant(P<0.05).Conclusion:1.The MVI MVI can display the micro-blood flow signals that can not be displayed by conventional ultrasound.The display of necrotic areas within the lesions is significantly better than that of conventional ultrasound that making up for the lack of conventional ultrasound in the diagnosis of thoracic lesions.there were a certain significance in the diagnosis of benign and malignant thoracic lesions lesions to determining the initial diagnosis of lesions prior to biopsy.2.Choosing the CEUS-enhanced region and the MVI-rich region as a sampling site will not only Avoiding blood vessels,choosing a safer approach to needle insertion and depth of needle insertion can effectively avoid necrotic tissue in the puncture,thereby increasing the puncture success rate,the rate of positive collection,the rate of pathological tissue necrosis and the incidence of complications.MVI have important guiding significance and clinical application value in the biopsy of thoracic lesions.