Diagnostic accuracy and complication rate of percutaneous ultrasound-guided coaxial biopsy combined with contrast-enhanced ultrasound in peri-pulmonary lesions / 中国医师杂志

ABSTRACT

Objective:To investigate the value of ultrasound-guided coaxial trocar biopsy combined with contrast-enhanced ultrasound in peripheral pulmonary lesions.Methods:From April 2019 to October 2020, 110 patients with peri-pulmonary lesions underwent ultrasound-guided coaxial trocar biopsy and contrast-enhanced ultrasound (CEUS) in Zhongshan People′s Hospital were retrospectively analyzed. All patients were performed contrast-enhanced ultrasound, at the same time, under the guidance of ultrasound, coaxial cannula was used for precise positioning and puncture biopsy of peripheral lung tumors. The times of puncture, the situation of sampling, pathological diagnosis and complications after puncture were recorded.Results:There were 110 lesions in 110 patients with peripheral lesions, and the maximum diameter of the lesions was (3.4±1.2)cm. Ultrasound guided coaxial trocar can be used for multiple, multi angle and multi-layer deep biopsy. The average number of sampling was 1-3, and the success rate of puncture was 100%(110/110). The pathological diagnosis rate was 95.5%(105/110), among which 83 cases (79.0%) were malignant 42 cases of adenocarcinoma, 19 cases of squamous cell carcinoma, 7 cases of metastatic adenocarcinoma, 4 cases of lymphoepitheliomatoid carcinoma, 4 cases of small cell carcinoma, 2 cases of non-small cell carcinoma, 2 cases of non-keratinized undifferentiated carcinoma, 2 cases of poorly differentiated carcinoma, and 1 case of rhabdomyosarcoma. 22 benign cases (21.0%) 10 inflammatory lesions, 4 pneumonia, 3 necrotic tissue, 2 tuberculosis, 1 atypical adenomatoid hyperplasia of alveolar epithelium, 1 pulmonary cryptococcosis, and 1 inflammatory pseudotumor. The postpuncture complications included pneumothorax 2.7%(3/110) and hemoptysis 0.9%(1/110).Conclusions:Percutaneous ultrasound-guided coaxial puncture biopsy combined with contrast-enhanced ultrasound has high success rate, rapid sampling, clear display of lesions, identification of tumor activity and necrosis area, accurate positioning of puncture target, multi-point sampling in case of one puncture, reducing puncture time and complications, and high clinical application value.