目的 探讨超声造影在周围型肺肿瘤经皮穿刺活检中的应用价值.方法 将 59例周围型肺肿瘤患者随机分为常规超声(灰阶超声及彩色多普勒超声)引导穿刺活检组(常规超声组27例)与超声造影引导穿刺活检组(超声造影组32例),术后将所取组织标本送病理检查,取材满足病理诊断为取材成功,分析两组肺肿瘤经皮穿刺活检取材成功率与准确率.结果 常规超声组经皮穿刺肺肿瘤活检取材成功率与准确率分别为92.6%(25/27)和77.7(21/27),超声造影组经皮穿刺肺肿瘤活检取材成功率与准确率分别为100%(32/32)和96.9%(31/32);超声造影组取材成功率与准确率均高于常规超声组,两组经皮穿刺肺肿瘤活检取材成功率(χ2=5.10,P<0.05)与准确率(Fisher检验P=0.025)比较差异有统计学意义.两组穿刺活检均无严重并发症发生.结论 超声造影可清晰显示病灶内的肿瘤活性区,区别坏死区,有助于穿刺取材部位的选择,提高穿刺取材的成功率与准确率,在周围型肺肿瘤穿刺活检中具有重要临床应用价值.%Objective To evaluate the clinical value of contrast-enhanced ultrasonography( CEUS ) in percutaneous lung biopsy of peripheral pulmonary tumors. Methods Fifty-nine patients with peripheral pulmonary tumors were randomly divided into two groups. CEUS-group( n = 32 ) underwent biopsy guided by contrast-enhanced ultrasound, while US-group( n = 27 ) guided by conventional ultrasound. After operation, tissue samples were sent for pathologic diagnosis. If the specimen for pathologic diagnosis was satisfied, which means a successful biopsy, then the biopsy achievement ratio and accuracy ratio were compared between the two groups. Results The achievement ratio and accuracy ratio of biopsy in CEUS-group were 100% ( 32/32 )and 96. 9%( 31/32 ),while US-group were 92. 6%( 25/27 )and 77. 7%( 21/27 ). The achievement ratio and accurate ratio of biopsy in CEUS-group were higher than those in US-group, the achievement ratio(x2 =5. 10, P < 0. 05 )and accurate ratio( Fisher tesst P = 0. 025 ) were statistically significant. There were no severe complications in both groups. Conclusion CEUS can display active areas clearly and guide puncture accurately and it can plays an important role in biopsing peripheral pulmonary tumors.
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