title: Contrast-enhanced ultrasound (CEUS) for the study of peripheral lung lesions: a preliminary study.
abstract: The use of contrast-enhanced ultrasound (CEUS) for the study of peripheral lung lesions has never been systematically investigated. We evaluated the CEUS patterns of 98 peripheral lung lesions before performing US-guided fine-needle biopsies (FNB). The examinations were done with an Esaote Technos MPX scanner in the harmonic mode with a mechanical index of 0.04 or less. Contrast enhancement was achieved with a 4.8 mL bolus of SonoVue (Bracco) administered via an antecubital vein. All FNBs performed under CEUS guidance were adequate for pathologic diagnosis. Seventy-eight lesions were malignant: 33 (41.9%) were adenocarcinomas, 29 (36.5%) were squamous-cell carcinomas, 13 (17.6%) were undifferentiated large-cell carcinomas and the remaining three (4.1%) were small-cell carcinomas. All presented intralesional enhancement consistent with tumor neovascularization. In some cases, there were unenhanced areas consistent with zones of necrosis and these areas were avoided during FNB. The other 20 lesions were benign (four lipomas, two fibrous lung tumor, two noncaseous granulomas, six abscesses, one rheumatoid nodule, one histiocytosis X, one chondroid hamartoma, one sclerosing hemangioma, two sarcoid nodules) and none presented intralesional enhancement. This initial and admittedly limited experience suggests that CEUS may provide diagnostically useful information on peripheral lung lesions and increase the diagnostic yield of transthoracic FNB by reducing the risk of inadequate tissue sampling.
authors.affiliation: Department of Internal Medicine; IRCCS, Casa Sollievo Della Sofferenza, Viale Cappuccini, San Giovanni Rotondo (FG), Italy. sperandeom@libero.it
authors.forename: Marco
authors.initials: M
authors.lastname: Sperandeo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sperandeo
authors.forename: Antonio
authors.initials: A
authors.lastname: Varriale
authors.forename: Paola
authors.initials: P
authors.lastname: Filabozzi
authors.forename: Marco
authors.initials: M
authors.lastname: Decuzzi
authors.forename: Lucia
authors.initials: L
authors.lastname: Dimitri
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Vendemiale
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods; D018287:Carcinoma, Large Cell / Q000000981:diagnostic imaging; D018288:Carcinoma, Small Cell / Q000000981:diagnostic imaging; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D045423:Microbubbles; D008875:Middle Aged; D010743:Phospholipids; D013459:Sulfur Hexafluoride; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride