Purpose: Description of the perfusion of pulmonary metastasis by contrast-enhanced ultrasound (CEUS) and their correlation with vascularization patterns represented by immunohistochemical CD34 endothelial staining. Patients and methods: The data of 54 patients with histologic proven peripheral pulmonary metastasis, investigated between 2004 and 2023 by CEUS. These CEUS parameters were evaluated: time to enhancement (TE), categorized as early pulmonary-arterial (PA) or delayed bronchial-arterial (BA) patterns; extent of enhancement (EE), either marked or reduced; homogeneity of enhancement (HE), homogeneous or inhomogeneous; and decrease of enhancement (DE), rapid washout (<120 s) or late washout (≥120 s). Additionally, tissue samples in 45 cases (83.3%) were stained with CD34 antibody for immunohistochemical analysis. Results: In total, 4 lesions (7.4 %) exhibited PA enhancement, and 50 lesions (92.6%) demonstrated BA enhancement. Furthermore, 37 lesions (68.5%) showed marked enhancement, while 17 lesions (31.5%) exhibited reduced enhancement. The enhancement was homogeneous in 28 lesions (51.86%) and inhomogeneous in 26 lesions (48.14%). Additionally, 53 lesions (98.1%) displayed a rapid washout. A chaotic vascular pattern indicative of a bronchial arterial blood supply was identified in all cases (45/45, 100%), including all 4 lesions with PA enhancement. Conclusion: Pulmonary metastases in CEUS predominantly reveal bronchial arterial enhancement and a rapid washout. Regarding EE and HE, pulmonary metastases show heterogeneous perfusion patterns. A PA enhancement in CEUS does not exclude BA neoangiogenesis.
目的：描述肺转移瘤在超声造影（CEUS）中的灌注特征，及其与免疫组化CD34内皮染色所显示的血管化模式之间的相关性。患者与方法：收集2004年至2023年间经CEUS检查且病理证实为周围型肺转移瘤的54例患者数据。评估以下CEUS参数：增强开始时间（TE），分为早期肺动脉（PA）型或延迟支气管动脉（BA）型；增强程度（EE），分为显著增强或减弱增强；增强均匀性（HE），分为均匀或不均匀；以及增强消退（DE），分为快速消退（<120秒）或延迟消退（≥120秒）。此外，对其中45例（83.3%）的组织样本进行了CD34抗体染色以进行免疫组化分析。结果：总计4个病灶（7.4%）表现为PA型增强，50个病灶（92.6%）表现为BA型增强。此外，37个病灶（68.5%）显示显著增强，17个病灶（31.5%）显示减弱增强。28个病灶（51.86%）增强均匀，26个病灶（48.14%）增强不均匀。另外，53个病灶（98.1%）显示快速消退。在所有病例（45/45，100%）中均识别出提示支气管动脉血供的紊乱血管模式，包括所有4个表现为PA型增强的病灶。结论：肺转移瘤在CEUS中主要表现为支气管动脉增强和快速消退。在增强程度和均匀性方面，肺转移瘤呈现异质性的灌注模式。CEUS中的PA型增强并不排除BA新生血管形成。
肿瘤(癌症)患者之家