目的：评估超声造影在区分恶性和良性周围性肺部病变中的诊断价值，并评估超声造影引导下活检对周围性肺部病变的可行性、准确性和实用性。方法：研究纳入了76例经组织病理学证实为周围性肺部病变的患者，40例穿刺前进行超声造影，为造影组；36例穿刺前行常规超声检查，为对照组，比较超声造影和常规超声显示病灶内坏死区域的能力，评估两组穿刺活检的阳性率。结果：在造影组中，急性肺炎病变的始增时间明显早于其他类型的病变（P= 0.03），良性和恶性病变之间的其他指标无显着差异；造影组病变内坏死区域显示率（47.5％）明显高于对照组（5.6％），超声造影引导的活检阳性率(90％)高于常规超声（72.2%），差异有统计学意义( P ＜ 0.05) 。结论：超声造影可以更好地识别病变内的坏死区域，从而在提高活检阳性率中发挥有效作用。超声造影有助于从其他类型的肺部病变中识别出急性肺炎病变。超声造影是诊断肺部病变的有用附加技术。

ABSTRACT:Purpose: To evaluate the diagnostic value of contrast-enhanced ultrasound in distinguishing malignant and benign peripheral lung lesions, and to evaluate the feasibility, accuracy and practicality of contrast-enhanced ultrasound-guided biopsy for peripheral lung lesions.Methods: This study included 76 patients with peripheral pulmonary disease confirmed by histopathology. 40 patients underwent contrast-enhanced ultrasound before puncture and were in the contrast group; 36 patients underwent routine ultrasound examination before puncture and were the control group. The ability of contrast-enhanced and conventional ultrasound to show the necrotic area within the lesion, and to evaluate the accuracy of the biopsy in the two groups.Results: In the contrast group, the initial increase time of acute pneumonia lesions was significantly earlier than that of other types of lesions (P = 0.03). There was no significant difference in other indicators between benign and malignant lesions; the display rate of necrotic areas in the lesions in the contrast group ( 47.5%) was significantly higher than the control group (5.6%), and the positive rate of contrast-enhanced ultrasound-guided biopsy (90%) was higher than that of conventional ultrasound (72.2%), and the difference was statistically significant (P <0.05). Conclusion: Contrast-enhanced ultrasound can better identify the necrotic area in the lesion, thereby playing an effective role in increasing the positive rate of biopsy. Contrast ultrasound helps to identify acute pneumonia lesions from other types of lung lesions. Contrast-enhanced ultrasound is a useful additional technique for diagnosing lung lesions.

内蒙古自治区自然科学基金项目(编号：2019LH08020）