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Purpose To evaluate the value of real-time contrast-enhanced ultrasound (CEUS) combined with comparative observation in determining the initial time of peripheral lung lesion,and to provide a new method for the diagnosis of peripheral lung disease by CEUS.Materials and Methods Sixty patients with peripheral lung disease diagnosed by chest X-ray or CT examination were examined by CEUS,and the lesions and perfusion of surrounding lung tissue were observed in real time and comparatively.The time of initial enhancement of peripheral lung lesion was determined by real-time comparative observation method,that is,to compare the time of contrast agent to reach the peripheral lung lesion with the time to reach the adjacent gas-containing lung tissue.All lesion specimens were obtained by surgery or ultrasound-guided percutaneous biopsy,and the pathological diagnosis was performed.According to the pathological results,the peripheral lung lesions were classified into the malignant group,the chronic inflammation group and the pneumonia group.Results Sixty cases of peripheral lung lesions were identified as 38 cases of malignant tumors (including 15 cases ofsquamous cell carcinomas,9 cases of adenocarcinoma cell carcinomas,2 cases of large cell carcinomas,9 cases of small cell carcinomas and 3 cases of metastatic carcinomas),14 cases of chronic inflammation lesions (including 7 cases of tuberculomas,3 cases of inflammatory pseudotumors and 4 cases of lung abscess) and 8 cases of pneumonia.The detection rates of pulmonary arterial phase and bronchial artery phase using the real-time comparative observation method were 100％ (60/60) and 85％ (51/60),respectively.The initial time of pulmonary arterial phase and bronchial artery phase were (6.1 ± 0.9) s and (10.5 ± 1.6) s,respectively.The initial time of pulmonary arterial phase was sooner than bronchial artery phase,the difference was statistical significance (P＜0.05).Conclusion The real-time CEUS combined with comparative observation method has important diagnostic value in judging the initial enhancement time of peripheral lung lesion and can provide a new method for the accurate diagnosis of peripheral lung disease,which is worth popularizing.
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Objective To compare the clinical effect of VATS and thoracotomy pulmonary wedge resection in treatment of pulmonary inflammatory pseudotumor. Methods 46 patients with pulmonary inflammatory pseudotumor were randomly divided into the observation group(24 cases) and the control group(22 cases) ,the control group were treated by thoracotomy pulmonary wedge resection and the observation group were treated by VATS wedge resection,the intraoperative blood loss,hospital stay, prognosis and complications were compared. Results All patients of two groups were cured and discharged. The intraoperative blood loss of observation group[(46. 0±12. 3 ) ml] was significantly less than the control group [(95.2 ± 18. 6) ml] ( t = 3. 19, P ＜ 0. 05 ), and the hospital stay was significantly shorter than the control group( t = 3.01,P ＜ 0. 05 ), the difference of the incidence of complications of two groups was not statistically significant( P ＞ 0. 05 ). Conclusion VATS wedge resection of pulmonary inflammatory pseudotumor had features of less bleeding and quicker healing characteristics,could be worthy of clinical application.
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Objective:To present clinical and pathologic features of pulmonary hyalnizing granuloma through analyzing three cases found in our institution and reviewing cases reported in the English language literature. Methods and Results: Three eases of pulmonary hyalnizing granuloma identified at our institu-tion during the past ten years were reviewed. In the first case, the patient presented with concurrent pulmonary hyalinizing granuloma and histoplasmosis. In the second case, the patient presented with a 5.5 cm lung mass and a separate smaller lesion radiologically resembling bronchogenic carcinoma. There was very prominent polyclonal lymphocytic proliferation at the periphery especially of the smaller lesion likely representing an early stage of the disease process. In the third case, the patient presented with multiple subpleural plaque-like lesions in addition to nodular lesions of the lung. All cases also demonstrated various degrees of lymphocytic infiltration within the lesions. The English literature has been reviewed through searching the PubMed. Conclusion: Since patients with pulmonary hyalinizing granuloma demonstrated a spectrum of clinical presentations, radiologic changes and histologic features with a variety of associated clinical disorders, pulmonary hyalnizing granuloma is more in keeping with a clinicopathologic entity rather than a specific pathologic disease.
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Objective: To assess the peculiarity of fluorine-18 fluorodeoxyglucose (FDG) uptake in pulmonary granuloma. Methods: From February, 2000 to April, 2002, 12 patients with pulmonary granuloma were imaged with FDG-PET (positron emission tomography) before surgery. The maximum and mean standard uptake value (SUVmax and SUVmean) of granuloma were measured and compared with SUV of normal lung (SUVlung). Results: All pulmonary granulomas were detected by FDG-PET. FDG uptake of granuloma was higher than that of normal lung (P
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Objective To analyze the CT characteristic of pulmonary inflammatory mass and peripheral lung cancer, and to look for the method of diagnosis solitary pulmonary nodule. Methods 28 patients of pulmonary inflammatory masses and 33 patients of peripheral lung cancers were included in the study,all patients conformed by pathology. The lesions were divided into typical and atypical masses according to morphology. Observing the signs of lesions and using the results ameliorate the morphological classification. Tested the method by ROC. Results According to the standard of morphology, the diagnosis sensitivity, specificity and accuracy of inflammatory mass are 64.3%, 72.7% and 68.9% respectively. The ameliorated sensitivity, specificity and accuracy are 75%, 81.8% and 78 7% respectively. Conclusion The method of making morphology as basement and sign as supplement can improve the sensitivity, specificity and accuracy of diagnosis.