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

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 decision - making 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. This suggests that diagnostic performance can be optimized by selecting appropriate guidance techniques based on lesion size and risk of complications.