在周围肺部病变中增强对比成像:在美国指导的活检中的作用
Xue-Yan Wang1, Zhi-Fan Yuan1, Ke-Hong Gan1
1From the Department of Medical Ultrasound, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China (X.Y.W., J.X.H., X.Q.P.); Department of Medical Ultrasound, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan, China (Z.F.Y., Y.H.X.); Department of Medical Ultrasound, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China (K.H.G.); and Department of Medical Ultrasound, The First People's Hospital of Foshan, Foshan, China (Y.Z., W.J.H.).
与标准超声波相比,对比增强超声波 (CEUS) 提高了外围肺病变活检的组织充分性和诊断准确性. 这种益处在2-7厘米之间的病变中最为显著.
科学领域:
- 肺部医学 肺部医学
- 放射学 放射学是指放射学
- 医疗成像医学成像
背景情况:
- 超声导向活检对于诊断周围肺病变 (PPL) 至关重要.
- 在这些活检中优化组织充分性和诊断准确性仍然是研究领域.
研究的目的:
- 为了比较对比增强超声波 (CEUS) 与美国指导的PPL活检中的标准超声波的有效性.
- 评估两种成像方式之间的组织充分性和诊断准确性的差异.
主要方法:
- 在四个医疗中心进行的回顾性研究分析了美国指导的1027个皮肤穿越胸腺针活检 (PTNB).
- 患者被分为标准超声波 (US) 和对比度增强超声波 (CEUS) 组.
- 进行了倾向分数匹配 (PSM) 和分层分析,考虑了病变大小.
主要成果:
- 与美国组相比,CEUS组的组织充分性 (98.2% vs 95.7%) 和诊断准确性 (96.9% vs 94.2%) 显著高于美国组.
- PSM分析证实,在2-7厘米大小的PPL中,CEUS的组织充分性和诊断准确性更高 (分别P=0.04和P=0.006).
- 对于大于7厘米的病变,在活检性能上没有发现显著差异.
结论:
- 预活检CEUS评估显著提高了组织充分性和诊断准确性,用于测量2-7厘米的PPL的美国指导PTNB.
- 美国标准指南与较大的PPL (>7厘米) 的CEUS相似.
- 在特定的外周肺病变大小中,CEUS是改善活检结果的有价值的辅助.
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