目的 探讨超声造影对超声引导下经皮肺穿刺活检的价值。方法 对96例患者进行了超声引导下经皮肺穿刺活检，其中穿刺前进行超声造影者54例（造影组），未进行超声造影者42例（非造影组）,比较两组患者穿刺成功率，分析超声造影对穿刺活检的影响。结果 造影组中恶性病变48例，良性病变6例;非造影组恶性病变36例，良性病变6例。超声造影显示41.7％(20/48)的恶性肿瘤内存在不同程度的坏死，且随着肿瘤体积增大，坏死比例增加，良性病变未显示明确坏死。非造影组一次穿诊断成功率为85.7％(36/42)，而造影组一次穿刺诊断成功率为98.1％(53/54)，两组穿刺成功率差异有统计学意义(P＜0.05)。非造影组穿刺失败的主要原因是所取组织为坏死或变性组织。结论 超声造影可显示周围性肺肿块的坏死情况，穿刺前进行超声造影有助于穿刺部位的选择，避开坏死组织，提高穿刺成功率。%Objective To investigate the role of contrast-enhanced ultrasound (CEUS) on the diagnostic efficacy of ultrasound-guided percutaneous biopsy of peripheral lung lesions. Methods Ninty-six patients with pleural-based lesions underwent percutaneous ultrasound-guided biopsy. Of the 96 patients,54patients underwent CEUS before biopsy and enhancement information was referred for the selecting of tissue sampling site. The rest of 42 patients didn' t undergo CEUS before biopsy. The difference in the diagnostic accuracy between the two groups was analyzed to evaluate the value of CEUS before biopsy.Results Of the 52 patients in the CEUS group,48 were malignant,and 6 were benign. Of the 42 patients in the un-CEUS group,36 were malignant, and 6 were benign. Necrosis (areas lacking of enhancement) was demonstrated in 41.7％ (20/48) of the patients with malignant lesions in CEUS group, and necrosis incidence was increased with the increase of the dimension of the malignant lesions. No necrosis area was demonstrated in 6 benign lesions. The rate of successful initial biopsy in CEUS group (98.1 ％ ,53/54) was statistically higher than that in un-CEUS group ( 85.7％, 36/42 ) ( P ＜ 0.05 ). Tissue necrosis and denaturalization attributed to most of the inconclusive pathologic diagnosis. Conclusions CEUS before transthoracic peripheral lung lesion biopsy improved the diagnostic accuracy of the procedure by providing information for differentiating viable or necrotic tissue and consequently provide more accurate information about the site of biopsy.
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