Abstract
Objectives. To investigate the value of contrast-enhanced ultrasound (CEUS) in guidance of percutaneous biopsy in peripheral pulmonary lesions. Methods. This study focused on 53 patients (male: 38, female: 15, and mean age: 55.7 years ± 10.7) with 53 single peripheral pulmonary lesions. Before core needle (16-gauge) percutaneous biopsy, CEUS were performed in all lesions, with injection of 2.4 mL SonoVue (Bracco, Italy). The contrast-enhancement pattern, display rate of internal necrosis (nonenhanced) and active (obviously enhanced) areas, biopsy success rate, and pathological diagnosis rate were recorded. Results. All the peripheral pulmonary lesions were proved pathologically as benign lesions (n = 7), primary malignancies (n = 41), or metastasis (n = 5). Forty (86.9%) malignant lesions and 4 (57.1%) benign lesions showed internal necrosis areas on CEUS. The detection rate and average size of internal necrosis areas had been significantly improved compared to conventional ultrasound (P < 0.05). After CEUS, core needle percutaneous biopsies were performed successfully in the active areas of all lesions. The sampling success rate and pathological diagnosis rate were 100% and 98.1%. Conclusions. CEUS before biopsy provided useful diagnostic information about peripheral pulmonary lesions. By depicting internal necrotic and active areas, it is a promising technique for guaranteeing the accuracy, success, and safety of core needle biopsy.
Highlights
Percutaneous biopsy guided by ultrasound is a well-established and reliable method for diagnosing peripheral pulmonary lesions, especially when adequate tissue specimens are difficult to be obtained by bronchoscopy [1]
It had similar diagnostic accuracy as biopsy guided by computed tomography (CT) [2]
The inclusion criteria were the following: (1) patients referred to the Department of Ultrasound in our institution for ultrasound guided percutaneous biopsy of pulmonary peripheral lesions and (2) pulmonary peripheral lesions that were detected on contrast-enhanced CT within one month and could have been visualized at conventional gray-scale ultrasound
Summary
Percutaneous biopsy guided by ultrasound is a well-established and reliable method for diagnosing peripheral pulmonary lesions, especially when adequate tissue specimens are difficult to be obtained by bronchoscopy [1]. It had similar diagnostic accuracy as biopsy guided by computed tomography (CT) [2]. As conventional ultrasound could not effectively distinguish necrotic areas in 9%– 26% of patients when the necrotic component is very large [4, 6], various methods had been applied to improve biopsy accuracy and to obtain adequate representative specimens, including using new biopsy needles, performing repeated biopsies, or making a cytopathologist present during biopsy [7]. The occurrence rate of complications may be increased with applications of those methods
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
