The Value of Necrotic Area Features in Contrast-Enhanced Ultrasound for Distinguishing Between Benign and Malignant Subpleural Pulmonary Lesions

Abstract

ObjectiveTo analyze Necrotic Area Features of subpleural pulmonary lesions (SPLs) demonstrated by contrast-enhanced ultrasound (CEUS) and investigate their value in differentiating between malignant and benign SPLs. MethodsPatients with SPLs who underwent CEUS at our hospital from January to May 2021. The following patient information was recorded: (i) age, (ii) sex, (iii) lesion size, (iv) lesion location, (v) size of necrotic areas and (vi) necrotic area morphology, including sieve-like necrosis, necrotic area with septal enhancement, necrotic area with annular enhancement margins, and necrotic area with burr-like enhancement margins. These parameters were analyzed using univariate and multivariate logistic regression. Subgroup analyses based on lesion size were further conducted using the collected data. ResultsA total of 212 patients with 212 SPLs were enrolled, comprising 99 benign and 113 malignant cases. Significant differences were observed between malignant and benign groups in terms of age, sex, lesion size and necrotic area morphology (all, p < 0.05). ConclusionNecrotic area's features observed on CEUS were valuable for distinguishing between benign and malignant SPLs. Age, sex, lesion size and the presence of burr-like enhancement margins are identified as independent predictors of malignant lesions.