Differential diagnosis of the peripheral lung lesions with new microvascular pattern of contrast-enhanced ultrasound
10.3760/cma.j.issn.1004-4477.2014.05.010
- VernacularTitle:新型超声造影微血管灌注模式对周围型肺占位的鉴别诊断
- Author:
Song WANG
;
Wei YANG
;
Kun YAN
;
Hui ZHANG
;
Lan MA
;
Yu SUN
;
Minhua CHEN
- Publication Type:Journal Article
- Keywords:
Ultrasonography;
Microbubbles;
Peripheral lung lesions;
Diagnosis,differential
- From:
Chinese Journal of Ultrasonography
2014;23(5):408-413
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of new microvascular pattern of contrast-enhanced ultrasonography (CEUS) in the diagnosis of peripheral lung lesion.Methods A total of 72 peripheral lung lesions which had been proved by clinical and pathology results underwent conventional ultrasound,CEUS and new microvascular pattern examination.Two independent readers (Reader 1 and Reader 2) blindly and retrospectively analysised and classified the characteristic of microvascular patterns respectively,and Kappa test was used for evaluating the concordance between the two readers.The diagnosis accuracy of CEUS was calculated,and the CEUS diagnostic scores were compared with conventional ultrasound.Results 16 benign lesions and 56 malignant lesions were enrolled in this study.The microvascular patterns in benign lesions included branch enhancement(43.8 ％,31.3％),point and patchy enhancement (18.8％,25.0％) and rim-like enhancement (18.8％,18.8％).The microvascular patterns in malignant lesions included vascular enhancement (46.4％,57.1％),cotton enhancement (26.8％,25.0％) and dead wood enhancement (19.6％,8.9％).There was significant difference between benign and malignant lesions.Kappa result showed that the two readers had a good diagnosis concordance(Kappa=0.759,P =0.000).According to the different types of microvascular pattern,the diagnostic accuracy,sensitivity,and specificity rates of two readers were 92.9％,91.1％;81.3％,75.0％ and 90.3％,87.5％,respectively.Before CEUS,59.7％ and 68.1％ of lesions were diagnosed as 3 by two readers respectively,while only 1.4％ and 6.9％ of lesions were diagnosed as 3 after CEUS.Further analysis demonstrated that there was significant difference in the microvascular pattern between squamous carcinoma and adenocarcinoma,and also between squamous carcinoma and small cell lung carcinoma.Conclusions Contrast-enhanced ultrasound could significantly increase the differential diagnosis of peripheral lung lesions.New microvascular pattern helped to display patterns of vascular perfusion.of peripheral lung lesions,and provide new diagnostic clue for differential diagnosis.
