摘要
目的分析超声造影及超声引导下经皮穿刺在获得性免疫缺陷综合征(acquired immune deficiency syndrome,AIDS)患者肺部病变的应用。方法选择2021年4月至2024年6月我院收治的AIDS合并肺部病变患者84例为对象,根据检查方法分为超声组39例和超声造影组45例。分析两组影像特征、超声特征、一次取材成功率、并发症情况及良恶性病变超声造影特征,分析造影剂到达时间(arrival time,AT)、平均渡越时间(mean transit time,MTT)、病变-肺时间(T_(at))在良恶性病变的诊断。结果超声造影组一次取材成功44例(97.78%)高于超声组33例(84.62%)(P<0.05);超声造影组发生并发症2例(4.44%)低于超声组发生5例(12.82%)。超声造影组良性病变中造影剂均匀增强16枚,恶性病变中造影剂均匀增强5枚,造影剂增强类型有显著差异(P<0.05)。良性病变的AT、MTT、T_(at)、Adler血流信号分级与恶性病变比较有显著差异(P<0.05),AT、MTT、T_(at)单独诊断良恶性病变的曲线下面积(area under the curve,AUC)值分别为0.817、0.741、0.878,联合诊断的AUC值为0.926,显著大于AT、MTT单独诊断的AUC值(P<0.05)。结论超声造影及超声引导下经皮穿刺可用于AIDS患者肺部病变诊断,具有临床应用意义,可提高一次性取材成功率,定量参数可用于诊断良恶性病变。
Objective To investigate the application of contrast-enhanced ultrasound and ultrasound-guided percutaneous puncture in pulmonary lesions in patients with acquired immune deficiency syndrome(AIDS).Methods According to the examination methods,84 patients with AIDS and pulmonary lesions were divided into ultrasound group with 39 cases and contrast-enhanced ultrasound group with45 cases.The images of the two groups were analyzed,and the ultrasound characteristics,the success rate of primary sampling,the occurrence of complications and the contrast-enhanced ultrasound characteristics of benign and malignant lesions were compared.The diagnostic value of agent arrival time(AT),mean transit time(MTT)and pathogen-to-lung time(T_(at))in the diagnosis of benign and malignant lesions were analyzed.Results Contrast-enhanced ultrasound and ultrasound-guided percutaneous puncture can be used for the diagnosis of pulmonary lesions in AIDS patients.There were no significant differences in ultrasound characteristics and the incidence of complications between the two groups(P>0.05).The success rate of primary sampling in contrast-enhanced ultrasound group was significantly higher than that in ultrasound group(P<0.05).Contrast-enhanced ultrasound features of benign and malignant lesions:There were significant differences in contrast enhancement types,blood flow signal grades of AT,MTT,T_(at) and Adler(P<0.05).The area under the curve(AUC)values of AT,MTT and T_(at) for the diagnosis of benign and malignant lesions alone were 0.817,0.741 and 0.878,respectively,and the AUC value of combined diagnosis of benign and malignant lesions was 0.926.The value of AUC was significantly higher than that of AT and MTT alone(P<0.05).Conclusion Contrast-enhanced ultrasound and ultrasound-guided percutaneous puncture have clinical application value in the diagnosis of pulmonary lesions in AIDS patients,which can improve the success rate of one-time sampling,and quantitative parameters can be used to diagnose benign and malignant lesions.
作者
阮光靖
农恒荣
蒙夏艳
何华伟
苏绮思
Ruan Guangjing;Nong Hengrong;Meng Xiayan;He Huawei;Su Qisi(Department of AIDS;Department of Ultrasound Medicine;Department of Tuberculosis Nanning Fourth People′s Hospital/Guangxi AIDS Clinical Treatment Center(Nanning)Nanning,530021,China)
出处
《中华肺部疾病杂志(电子版)》
2025年第4期592-597,共6页
Chinese Journal of Lung Diseases(Electronic Edition)
基金
自治区卫生健康委自筹经费科研课题(Z-A20241083,Z-A20231210)。
关键词
获得性免疫缺陷综合征
超声造影
肺部病变
Acquired immunodeficiency syndrome
Contrast-enhanced ultrasound
Lung lesions
Pneumonia
