The role of quantitative analysis of contrast-enhanced ultrasound combined with tumor marker in the diagnosis of peripheral pulmonary lesions

Abstract

Objective To explore the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of peripheral pulmonary lesions, and to evaluate the diagnostic efficiency of CEUS combined with tumor markers peripheral lung cancer. Methods According to the pathological results, 105 patients with 105 peripheral pulmonary lesions were divided into benign (50 cases) and malignant group (55 cases). Before CEUS examination, lesions′ location, size, shape and internal echogenicities were recorded by two-dimensional (2D) ultrasound. After contrast agent injection, arrive time (AT) in the lesion, difference of AT between the lesion and lung (tAT), and lesions′ enhanced morphology were observed. The time intensity curve (TIC) was used to obtain the rise time (RT), mean transit time (MTT), time from peak to one half of peak(TPH), time to peak (TTP), peak intensity (PI) and wash-in slope (WIS). The parameters of TIC between the two groups were compared. Serum carcino-embryonic antigen (CEA), neuron specific enolase (NSE) and cyrokeratin fragment antigen 21-1 (CYFRA21-1) level were detected and analyzed between the two groups. Results Lesions′ shape and intralesional bronchial syndrome had significant difference in the diagnosis of peripheral pulmonary benign and malignant lesions (P<0.01). In benign group, 27 lesions (54.00%, 27/50) were enhanced in late pulmonary arterial phase and 32 lesions(64.00%, 32/50)showed homogeneous enhancement. At the meantime, in malignant group, most of lesions (76.36%, 42/55) were enhanced in bronchial arterial phase and 36.00% (18/50) of lesions indicated inhomogeneous enhancement. The difference of enhanced phase and morphology between benign and malignant lesions were significant (all P<0.05). While the statistical differences of such quantitative parameters AT, tAT, RT, TTP, PI and WIS, except to MTT and TPH were found between benign and malignant lesions (all P<0.05) in experiment group. In the diagnosis of peripheral lung cancer, the accuracy and specificity of tAT combined with joint detection of 3 kinds of tumor markers were 76.37% and 75.00%, respectively, and higher than any single detection, but the sensitivity was a little lower(76.47%). Conclusions CEUS quantitative analysis has certain value in the diagnosis of benign and malignant peripheral lung lesions, and combined with tumor markers can improve the diagnostic efficiency of peripheral lung cancer. Key words: Contrast-enhanced ultrasound; Pulmonary neoplasms; Tumor markers