Comparison of the application value of contrast-enhanced ultrasound and contrast-enhanced CT in puncture biopsy of peripheral pulmonary lesions

Gang Wang ¹ Zhihua Wang ² Ji-cheng Zhang ³ Xiaolin Liu ² Gang Liu ² Bo Gou ³ Liu Jian ^3*

• ¹ Department of Ultrasound Medicine, the Shaoyang Central Hospital of Hunan Province, Shaoyang, Hunan, China., Shaoyang, China
• ² The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong Hospital of Beijing Anzhen Hospital Capital Medical University, Nanchong, China
• ³ Department of Ultrasound, First Affiliated Hospital of Chengdu Medical College, Chengdu, China

Objective: This study assesses the clinical utility of contrast -enhanced ultrasound (CEUS) in comparison to contrast -enhanced computed tomography (CECT) in the context of peripheral lung mass biopsy. The overarching objective is to establish robust clinical benchmarks that can guide evidence -based decisionmaking in the field of pulmonary interventional procedures.Methods: A comparison of 420 patients admitted to our hospital from January 2019 to December 2022 who underwent biopsy using two different guidance methods, including 196 cases in the CEUS-guided biopsy group and 224 cases in the CECT-guided biopsy group. The average number of pleural punctures, puncture time, satisfaction with the first puncture specimen, diagnostic accuracy and complication rate were compared between the two guidance methods.Results: (1) Compared with the CECT group, the CEUS-guided group required fewer pleural punctures (2.5 vs. 4.1 times) and shorter puncture time (24 minutes vs. 42 minutes) on average, and the difference was statistically significant. (P<0.001). ( 2) In terms of complications, the incidence of pneumothorax (3.1% vs. 8%) was lower in the CEUS group, while the incidence of bleeding (1.5% vs. 3.1%) had no significant difference between the two groups. (3) When the diameter of the lesion is <3 cm, the specimen satisfaction and diagnostic accuracy of the CEUS group are lower than those of the CECT group (71.0% vs. 88.3%, 64.5% vs. 86.7%). When the diameter of the lesion is (3 ~ 6cm), the specimen satisfaction and diagnostic accuracy of the CEUS group were higher than those of the CECT group (98.6% vs. 89.6%, 95.8% vs. 85.2%), and the above differences were statistically significant; but when the diameter of the lesion was >6cm, There was no significant difference in specimen satisfaction rate and diagnostic accuracy between the two guidance methods.Conclusion: CEUS is better than CECT in reducing the number of punctures, shortening puncture time and reducing the incidence of pneumothorax, and is especially suitable for the diagnosis of medium-sized lesions. However, for lesions less than 3 cm in diameter, CECT demonstrated higher specimen satisfaction and diagnostic accuracy.