中文摘要：

目的探讨实时超声造影（CEUS）引导下的经皮肺穿刺活检对肺周围型及纵隔病灶诊断的应用价值。方法收集2012年5月-2014年5月经CT或MRI发现肺周围型或纵隔病变,于广州中医药大学第一附属医院超声科经常规超声引导下肺周围型或纵隔病灶穿刺活检患者62例为超声组（US）,另收集2014年6月-2016年6月经CT或MRI发现肺周围型或纵隔病变,且于广州中医药大学第一附属医院超声科行超声造影同时进行超声引导下经皮胸穿刺活检患者78例为超声造影组（CEUS）,对比2组的声像图特征、穿刺针数、取材成功率、并发症发生率的差异。结果 US组和CEUS组坏死检出率分别为8.1%和44.9%（P〈0.001）,病灶出现坏死的比例随着病灶体积增大而增加。US组穿刺平均针数为（2.6±0.6）,CEUS组穿刺平均针数为（2.3±0.8）,差异有统计学意义（P=0.015）。US组和CEUS组取材成功率分别为93.5%和100.0%,差异有统计学意义（P=0.036）。US组穿刺并发症发生率为4.8%,CEUS组穿刺并发症发生率为1.3%,2组比较差异无统计学意义（P=0.322）。结论实时超声造影在肺周围型及纵隔病灶的经胸穿刺的路线选择方面具有重要作用,可以提高穿刺成功率,降低操作风险。

英文摘要：

Objective To evaluate the application value of real time contrast-enhanced ultrasound（CEUS）guided percutaneous transthoracic needle biopsy in the diagnosis of pulmonary peripheral and mediastinal lesions.Methods 62 cases of patients with peripheral pulmonary or mediastinal lesions diagnosed by CT or MRI in the First Affiliated Hospital of Guangzhou University of Chinese Medicine underwent peripheral pulmonary or mediastinal lesions biopsy guided by ultrasound From May 2012-May 2014 years were named as Ultrasound（US）group;in addition,78 cases of patients with periphery pulmonary or mediestinal lesions diagnosed by CT or MRI underwent percutaneous transthoracic needle biopsy under the guidance of CEUS were named as CEUS group.Comparison was performed between the two groups in the case of acoustic image features,number of puncture,success rate of biopsy and incidence of complication rate.Results The detection rate of necrosis in US and CEUS group was 8.1% and 44.9%,respectively（P 0.001）,and the proportion of necrosis increased as the volume of lesion increased.The average needle number of US group was（2.6±0.6）,and the mean needle number of CEUS group was（2.3±0.8）,the difference was statistically significant（P =0.015）.The successful rate of biopsy in US group and CEUS group was 93.5%and 100%,respectively,and the difference was statistically significant（P =0.036）.The complication rate of US group and CEUS group was 4.8% and 1.3%,respectively.No statistically significant difference can be observed between the two groups（P =0.322）.Conclusion Real time contrast-enhanced ultrasound was exhibited to play an important role in the choice of transthoracic approach for peripheral pulmonary and mediastinal lesions,which was shown to be able to improve the success rate of puncture and reduce the risk of operation