周围型肺鳞癌及肺腺癌超声造影初步研究

摘要

目的 分析周围型肺鳞癌及肺腺癌的超声造影增强模式及声学造影定量参数,探讨周围型肺鳞癌及肺腺癌的造影表现特征.方法 回顾分析经超声造影后穿刺活检病理证实的52例周围型肺鳞癌(鳞癌组)和58例周围型肺腺癌(腺癌组)的超声造影增强表现,并应用QLAB软件制作时间-强度曲线(TIC),获取并比较两组声学造影定量参数.结果 ①不均匀增强、 低增强是两组病例造影后的共同主要表现,其在鳞癌组与腺癌组出现率分别为76.9%、86.5%和67.2%、75.9%;②鳞癌组以局部-整体型增强模式为主(37/52),可见整体增强型及周边始增型;腺癌组以周边始增型模式为主(33/58),可见整体增强型及血管样始增型;③鳞癌组无增强区多于腺癌组,差异有统计学意义(P<0.05);④两组患者TIC曲线均呈"尖峰型",鳞癌组以"速升缓降"表现为主,腺癌组以"速升速降"表现为主.鳞癌组始增时间、峰值减半时间均短于腺癌组,曲线下降支斜率大于腺癌组,两组比较差异均有统计学意义(均P<0.05);而两组达峰时间、上升时间、基础强度、增强强度、峰值强度及曲线上升支斜率比较差异均无统计学意义.结论 分析超声造影增强表现的特点及声学造影定量参数的不同,对周围型肺鳞癌及肺腺癌的诊断有一定的提示意义.%Objective To investigate the characteristics of contrast-enhanced ultrasonography of peripheral pulmonary squamous cell carcinoma and pulmonary adenocarcinoma by analyzing the patterns of contrast-enhanced ultrasound and the quantitative parameters of acoustic contrast. Methods The sonographic features of contrast-enhanced ultrasound of 52 patients with peripheral pulmonary squamous cell carcinoma and 58 patients with peripheral pulmonary adenocarcinoma were analyzed retrospectively,which confirmed by puncture biopsy after contrast-enhanced ultrasound. QLAB software was used to draw time-intensity curve(TIC) and the acoustic contrast quantitative parameters were recorded at the same time. Results ①Inhomogeneous enhancement and hypo-enhancement were the main manifestations of contrast-enhanced ultrasound of the patients in two groups,the rate of occurrence in peripheral pulmonary squamous cell carcinoma were 76.9%,86.5%,and 67.2%,75.9% in peripheral pulmonary adenocarcinoma,respectively. ②The main performance of contrast-enhanced ultrasound of peripheral pulmonary squamous cell carcinoma were partial-whole enhancement mode(37/52),showing overall enhancement and peripheral enhancement beginning type. The main performance of contrast-enhanced ultrasound of peripheral pulmonary adenocarcinoma were peripheral enhancement beginning mode(33/58), showing overall enhancement and vascular morphology enhancement beginning pattern. ③Local none-enhanced pattern was the characteristic manifestation of peripheral pulmonary squamous cell carcinoma,and the difference was statistically significant compared with pulmonary adenocarcinoma(P<0.05).④TIC curves of two groups presented"spike type",the main performance of peripheral pulmonary squamous cell carcinoma was"speed up and slow down",while peripheral pulmonary adenocarcinoma was mainly manifested as "steep in rise and drop down". AT and T1/2 of peripheral pulmonary squamous cell carcinoma were both shorter than those of peripheral pulmonary adenocarcinoma,whileαwas greater than that of peripheral pulmonary adenocarcinoma,the differences were statistically significant between two groups(all P<0.05). The differences of TTP,RT,BI,EI,PI and βwere not statistically significant between two groups. Conclusion The analysis of the characteristics of contrast-enhanced ultrasonography and the differences of the quantitative parameters of acoustic contrast can provide certain significance in the diagnosis of peripheral pulmonary squamous cell carcinoma and pulmonary adenocarcinoma.