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中华医学超声杂志(电子版) ›› 2023, Vol. 20 ›› Issue (11) : 1181 -1185. doi: 10.3877/cma.j.issn.1672-6448.2023.11.012

胸部超声影像学

超声造影评价肺腺癌与肺鳞癌血流灌注特征的价值研究
赵鑫, 郝磊, 朱丽静, 土继政, 王博娟, 张凯, 王兴华()   
  1. 030001 太原,山西医科大学医学影像学院
    030001 太原,山西医科大学第二医院超声科
  • 收稿日期:2022-10-20 出版日期:2023-11-01
  • 通信作者: 王兴华
  • 基金资助:
    山西省科技厅重点研发计划项目(201703D421029)

Value of contrast-enhanced ultrasonography in evaluating blood perfusion characteristics of pulmonary adenocarcinoma and squamous cell carcinoma

Xin Zhao, Lei Hao, Lijing Zhu, Jizheng Tu, Bojuan Wang, Kai Zhang, Xinghua Wang()   

  1. Medical Imaging Department of Shanxi Medical University, Taiyuan 030001, China
    Department of Ultrasound, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China
  • Received:2022-10-20 Published:2023-11-01
  • Corresponding author: Xinghua Wang
引用本文:

赵鑫, 郝磊, 朱丽静, 土继政, 王博娟, 张凯, 王兴华. 超声造影评价肺腺癌与肺鳞癌血流灌注特征的价值研究[J/OL]. 中华医学超声杂志(电子版), 2023, 20(11): 1181-1185.

Xin Zhao, Lei Hao, Lijing Zhu, Jizheng Tu, Bojuan Wang, Kai Zhang, Xinghua Wang. Value of contrast-enhanced ultrasonography in evaluating blood perfusion characteristics of pulmonary adenocarcinoma and squamous cell carcinoma[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(11): 1181-1185.

目的

对比分析肺腺癌与肺鳞癌超声造影增强特征,探讨超声造影评价肺腺癌与肺鳞癌血流灌注特征差异的应用价值。

方法

回顾性选取2017年10月至2021年12月于山西医科大学第二医院经病理确诊的54例(54个病灶)肺腺癌与46例(46个病灶)肺鳞癌患者,采用χ2检验对比分析二者超声造影增强特征的差异,包括增强时相(肺动脉增强、支气管动脉增强)、增强模式(基底树枝型增强、杂乱血管型增强)及达峰模式(均匀型增强、不均匀型增强)。

结果

肺腺癌与肺鳞癌超声造影增强特征呈现一定差异,增强时相表现为肺动脉增强的病灶肺腺癌(70.4%,38/54)多于肺鳞癌(45.7%,21/46);增强模式表现为基底树枝型增强的病灶肺腺癌(20.4%,11/54)多于肺鳞癌(4.3%,2/46);达峰模式表现为不均匀型增强的病灶肺鳞癌(67.4%,31/46)多于肺腺癌(16.7%,9/54),差异均具有统计学意义(χ2=6.274、5.638、26.630,P=0.012、=0.018、<0.001)。

结论

肺腺癌与肺鳞癌的超声造影增强特征存在一定差异,超声造影可评估二者血流灌注差异,对其临床治疗方案的选择及鉴别诊断具有潜在的临床应用价值。

Objective

To compare and analyze the enhancement characteristics of pulmonary adenocarcinoma (ADC) and squamous cell carcinoma (SCC) on contrast-enhanced ultrasonography (CEUS), and to investigate the value of CEUS in evaluating the differences in blood perfusion characteristics of ADC and SCC.

Methods

A total of 54 patients with pulmonary ADC and 46 patients with SCC confirmed by pathology at the Second Hospital of Shanxi Medical University from October 2017 to December 2021 were retrospectively selected. The chi-square test was used to compare the CEUS characteristics between pulmonary ADC and SCC, including the enhancement phase (early pulmonary-arterial [PA] pattern of enhancement, delayed bronchial-arterial [BA] pattern of enhancement), enhancement pattern (basal dendritic enhancement, chaotic vascular enhancement), and peak pattern of CEUS (homogeneous enhancement, inhomogeneous enhancement).

Results

There were some differences in the enhancement characteristics between ADC and SCC, with more ADC (70.4%, 38/54) than SCC (45.7%, 21/46) cases showing PA pattern of enhancement in the enhancement phase; more ADC (20.4%, 11/54) than SCC (4.3%, 2/46) cases showing basal dendritic enhancement in the enhancement pattern; and more SCC (67.4%, 31/46) than ADC (16.7%, 9/54) cases showing inhomogeneous enhancement in the peak pattern; the differences were statistically significant χ2=6.274, 5.638, and 26.630; P=0.012, =0.018, and <0.001, respectively).

Conclusion

There are some differences in enhancement characteristics of CEUS between ADC and SCC. CEUS can evaluate the differences in blood perfusion characteristics between them, and has potential clinical value in the selection of treatment plan and differential diagnosis of ADC and SCC.

图1 超声造影增强模式示意图。图a为基底树枝型增强模式示意图,造影剂呈树枝样从病灶基底部迅速弥漫性增强。图b为杂乱血管型增强模式示意图,造影剂在病灶内呈多支杂乱无序血管样增强
表1 肺腺癌与肺鳞癌患者基本临床特征比较
表2 肺腺癌与肺鳞癌超声造影增强特征比较[例(%)]
图2 78岁男性肺鳞癌患者超声图像。图a:普通二维超声表现。图b:超声造影17 s时病灶与胸壁同时增强,为支气管动脉增强,该病灶呈杂乱血管型增强,白色箭头为病灶增强,红色箭头为胸壁增强。图c:21 s时病灶达峰模式为不均匀型增强
图3 67岁女性肺腺癌患者超声图像。图a:普通二维超声表现。图b:超声造影8 s时病灶开始呈基底粗大树枝样增强。图c:超声造影14 s时病灶达峰模式为均匀型增强。此时胸壁仍未开始增强,故该病灶为肺动脉增强
表3 不同病灶最大径组内肺腺癌与肺鳞癌超声造影达峰模式比较[个(%)]
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