OBJECTIVE:To develop and validate a deep learning model integrating multi-modal ultrasound information from B-mode ultrasound (BMUS) and strain elastography (SE) for accurate preoperative prediction of central lymph node metastasis (CLNM) in patients with papillary thyroid carcinoma (PTC). METHODS:In this retrospective multi-center study, 568 patients with PTC from 4 hospitals were enrolled and divided into a training set (n = 400), an internal validation set (n = 100) and an external test set (n = 68). BMUS and SE images were collected for each patient. After image pre-processing, deep features were extracted from each modality using EfficientNet-B4 and fused for CLNM prediction. Model performance was evaluated using the area under the curve (AUC), accuracy, sensitivity and specificity. Calibration and decision curve analysis were further performed. Diagnostic performance was further compared with radiologists of different experience levels, with and without artificial intelligence assistance. RESULTS:In the internal validation set, the multi-modal fusion model achieved an AUC of 0.929, outperforming the BMUS-only (AUC = 0.843) and SE-only (AUC = 0.875) models. In the external test set, the model maintained good generalizability with an AUC of 0.843. Calibration and decision curve analysis demonstrated good agreement and clinical net benefit. Grad-CAM visualizations demonstrate a potential alignment between the regions attended to by the model and clinical signs. The proposed model outperformed all individual radiologists (AUC range, 0.585-0.649), and artificial intelligence assistance improved radiologists' diagnostic performance (AUC increased to 0.701-0.752) and confidence. CONCLUSIONS:The proposed multi-modal deep learning model enables accurate and interpretable preoperative prediction of CLNM in PTC patients, demonstrating robust performance across centers and effective clinical decision support potential.

The automatic screening of thyroid nodules using computer-aided diagnosis holds great promise in reducing missed and misdiagnosed cases in clinical practice. However, most current research focuses on single-modal images and does not fully leverage the comprehensive information from multimodal medical images, limiting model performance. To enhance screening accuracy, this study uses a deep learning framework that integrates high-dimensional convolutions of B-mode ultrasound (BMUS) and strain elastography (SE) images to predict the malignancy of TI-RADS 4 thyroid nodules with high-risk features. First, we extract nodule regions from the images and expand the boundary areas. Then, adaptive particle swarm optimization (APSO) and contrast limited adaptive histogram equalization (CLAHE) algorithms are applied to enhance ultrasound image contrast. Finally, deep learning techniques are used to extract and fuse high-dimensional features from both ultrasound modalities to classify benign and malignant thyroid nodules. The proposed model achieved an AUC of 0.937 (95 % CI 0.917-0.949) and 0.927 (95 % CI 0.907-0.948) in the test and external validation sets, respectively, demonstrating strong generalization ability. When compared with the diagnostic performance of three groups of radiologists, the model outperformed them significantly. Meanwhile, with the model's assistance, all three radiologist groups showed improved diagnostic performance. Furthermore, heatmaps generated by the model show a high alignment with radiologists' expertise, further confirming its credibility. The results indicate that our model can assist in clinical thyroid nodule diagnosis, reducing the risk of missed and misdiagnosed diagnoses, particularly for high-risk populations, and holds significant clinical value.

目的 评价超声造影指导肝穿刺诊断肝脏占位性病变的临床应用价值.方法 回顾性分析在我科行肝脏穿刺活检术的80例肝脏占位性病变患者的临床资料,其中50例术前行超声造影检查,30例术前行常规灰阶超声检查.比较两组的诊断效能.结果 与灰阶超声检查比,超声造影检查组显示病灶内部坏死区显著提高(56.0％对30.0％,P=0.024),取材成功率显著提高(100.0％对90.0％P=0.022),两组穿刺次数差异无统计学意义(3.0±0.8对2.9±0.8,P=0.590);超声造影组诊断的灵敏度为97.8％、特异度为100％、准确率为98.0％,均显著高于灰阶超声组(分别为80.8％、75.0％和80.0％,P均<0.05).结论 超声造影检查能够提高超声引导下肝脏穿刺活检术取材的成功率和诊断效能,值得临床应用.

Objective To analyze the epidemiology and disease characteristics of thyroid nodules in a healthy population to provide clinical assistance in diagnosis and treatment. Methods The ultrasonic testing results of 58 094 people who received health checkup at the First Affiliated Hospital of Anhui Medical University from January to December in 2018 were retrospectively collected. The pathological results and ultrasonic classification of nodules by the results of thyroid imaging report and data system (TI-RADS) were analyzed to understand the type and age distribution of thyroid nodules in Hefei area. Results A total of 24 047 cases (41.39%) of thyroid nodules were found in this research. The results showed that the prevalence of thyroid nodules increased gradually with age (χ2=2 017.00, P<0.01), the prevalence of nodules in men in all age groups were all significantly lower than those in women (all P<0.01). In different TI-RADS classifications, the proportions of left lobe, right lobe, and bilateral lobe in the diseased area were statistically significant (all P<0.01). The prevalence of TI-RADS was 17.30% (10 050/58 094), 22.70% (13 189/58 094), 1.23% (713/58 094), 0.15% (87/58 094), 0.01% (5/58 094), and 0.01% (3/58 094) for thyroid nodule types 2, 3, 4a, 4b, 4c, and 5, respectively, and there was a significant difference in the prevalence of thyroid nodules of different types (χ2=48 000.00, P<0.01). Three hundred and twelve patients were definitely diagnosed with carcinoma, of which 242 were benign and 70 were malignant, and the difference in the prevalence of malignancies among different TI-RADS types was statistically significant (χ2=42.79, P<0.01). Among them, papillary thyroid carcinoma accounted for 84.28% (59/70). Conclusion The prevalence of thyroid nodules is high. Age and gender are closely related to the prevalence of thyroid nodules. Key words: Thyroid nodules; Ultrasonography; Epidemiology; Prevalence rate; TI-RADS classification

目的 分析健康人群甲状腺结节流行病学及患病特征,为临床诊治提供帮助.方法 根据2018年1月至12月安徽医科大学第一附属医院58094名体检者的甲状腺超声检查的结果,结合甲状腺影像学报告及数据系统TI-RADS分类方法对各种类型结节进行回顾性分析,对TI-RADS 4～5类高危结节病理结果及超声分类进行分析.通过本次研究了解合肥地区人群甲状腺结节类型和年龄分布,为高危人群的筛选提供参考.结果 本组体检人群中,甲状腺结节患病24047例,患病率41.39％(24047/58094).统计显示:随着年龄增长甲状腺结节患病率逐渐升高(χ2=2017.00,P<0.01);男性在各个年龄组的患病率均低于女性,且差异均有统计学意义(均P<0.05).不同TI-RADS分类中患病部位左侧叶、右侧叶和双侧叶构成比差异均具有统计学意义(均P<0.01).TI-RADS 2类甲状腺结节患病率为17.30％(10050/58094)、3类患病率为22.70％(13189/58094)、4a类患病率为1.23％(713/58094)、4b类患病率为0.15％(87/58094)、4c类患病率为0.01％(5/58094)、5类患病率为0.01％(3/58094),TI-RADS不同类患者患病率差异有统计学意义(χ2=48000.00,P<0.01).312例患者明确诊断,良性242例,恶性70例,比较不同TI-RADS分类中的恶性患病率,差异有统计学意义(χ2=42.79,P<0.01).其中甲状腺乳头状癌59例在恶性中占比84.28％(59/70).结论 甲状腺结节患病率较高,年龄及性别与其患病密切相关,超声对甲状腺结节筛查有重要意义.

目的 探讨乳腺超声BI-RADS分级与病理检查结果在诊断乳腺癌过程中的相关性及运用价值.方法 选取70例有乳腺包块患者,先对其进行超声BI-RADS分级评估,再进行术后病理检查,分析两者的相关性及运用价值.结果 70例患者中被评估为5级23例,4a级17例,4b级10例,4c级13例,3级7例,BI-RADS 5级和病理检查结果基本一致,BI-RADS 3～4级和病理检查结果对比,差异有显著性(P<0.05).乳腺肿块直径<2 cm,纵横比<1的乳腺癌患者与良性乳腺疾病患者的鉴别诊断中,超声BI-RADS分级评估仍然有一定的困难,与病理检查结果对比差异有显著性.结论 超声BI-RADS分级对乳腺癌的准确诊断具有重要价值,已逐步成为乳腺癌筛选的常规检查方法.

Objective: There is a great controversy about whether the internal jugular vein (IJV) should be retained during radical neck dissection. In this study, the right and left IJV under different body position were observed by color Doppler ultrasound, in order to provide a experimental basis for the preservation of IJV in neck dissections. Methods: A total of 40 patients with thyroid cancer undergoing radical neck dissection were examined in this study. The hemodynamic data such as section area, velocity, and volume of blood flow were measured by Doppler in supine and sitting position under quiet breath. Results: In supine position, the cross sectional area, the velocity and the blood flow volume in the right side were 58%, 23% and 91% more than left side respectively. The right side advantage, symmetrical, and left side advantage of IJV was in 65%, 25%, and 10% of patients. The blood flow of bilateral IJV was 74% of total cerebral outflow. The IJV predominate, balanced type, and no-IJV predominate cerebral venous drainage was in 73%, 23% and 5% of patients. In sitting position, the section area, the velocity and the blood flow volume in the right side were 29%, 35% and 56% more than left side respectively. The right side advantage, symmetrical, and left side advantage of IJV was in 45%, 45%, and 10% of patients. The blood flow of bilateral IJV was 23% of total cerebral outflow. The balanced type and no-IJV predominate cerebral venous drainage was in 23% and 78% of patients. Conclusions: There are side advantage of IJV. With quiet breathing, IJV is not the main pathway of cerebral venous drainage in sitting position. The preoperative ultrasound is useful to design the individualized surgical approach for the radical neck dissections.

Objective To evaluate the left ventricular diastolic function by two dimensional speckling tracking techonolgy(2D-STI)in patients with type 2 diabetes mellitus disease(2-DM). Methods 30 DM patients (group DM) patients and 31 healthy controls during January 2015 to December 2015 in the 105th Hospital of People′s Liberation Army were enrolled in this study. Echocardiography was performed in all the patients and the healthy controls. High quantity two dimensional gray scale imagings were acquired,and LsSRe,LsSRa,CsSRe, CsSRa,then separately to calculate the mean of LgSRe,LgSRa,CsSRe,CsSRa. And Calculate LgSRe/LgSRa, CgSRe/CgSRa,E/LgSRe,E/CgSRe were measured. Results ⑴Compared with control group,there was no signicanficant different in general parameters (P>0.05). ⑵Compared with control group,2-DM group LsSRe was signicanficant decrease (P<0.05),and LgSRe was signicanficant decrease (0.88±0.17 vs 1.30 ±0.22,P<0.05), LgSRe/LgSRa was decrease and value less than 1 (0.91 ±0.19 vs 1.20 ±0.39,P<0.05),E/LgSRe was incease (0.92±0.16 vs 0.67±0.22,P<0.05). ⑶There was no different in Circumeferential Segment Strain Rate(P>0.05). Conclusion 2D-STI can access the left ventricular diastolic function in patients with DM objectively and expediently.

Objectives: The aim of this study was to evaluate the flow dynamics of cerebral bridging veins (BVs) entering superior sagittal sinus (SSS) by color-coded duplex sonography, in order to provide morphologic and hemodynamic basis for related disease. Methods: Twenty patients with selective craniotomy one year ago and having a good recovery underwent color-coded duplex sonography. The morphologic and hemodynamic data were measured through the surgical bone window. Results: The BVs formed two clusters along the SSS: anterior group and posterior group. The number of the anterior group BVs was 3.1 +/- 1.4, the diameter was 2.7 +/- 0.7 mm, the angle was 96 +/- 33 degrees, the mean flow velocity was 10.0 +/- 2.8 cm/s, and the blood flow volume was 28.21 +/- 14 +/- 88 ml/min. The number of the posterior group BVs was 5.8 +/- 1.0, the diameter was 3.2 +/- 1.2 mm, the angle was 41.24 degrees, the mean flow velocity was 11.4 +/- 2.8 cm/s, and the blood flow volume was 48.12 +/- 38.13 ml/min. The number, diameter, the mean flow velocity, and the blood flow volume of the posterior group BVs were larger than anterior group. When the BV entered SSS with less than 90 degrees, the turbulent flow was found in the SSS and BV besides dural entrance. Conclusion: The morphological and hemodynamic feature of BVs entering SSS can be measured through the surgical bone window by color-coded duplex sonography.

目的 探究眼血流动力学参数对颈动脉狭窄型缺血性脑血管疾病诊断价值研究.方法 分析2013年6月至2014年12月在我院接受治疗的脑梗死伴颈动脉狭窄患者的临床资料,设为观察组.同时选取同期在我院进行健康检查的患者作为对照组.结果 观察组患者眼动脉(OA)的收缩期峰值流速(PSV)(t=3.299,P=0.001)、舒张末期血流速度(EDV)(t =2.862,P＜0.001)明显低于对照组,组间差异具有统计学意义(P＜0.05);观察组患者视网膜中央动脉(CRA)的PSV(t=5.224,P＜0.001)、阻力指数(RI)(t =4.465,P＜0.001)、搏动指数(PI)(t =6.630,P＜0.001)参数明显低于对照组,组间差异具有统计学意义(P＜0.05);颈动脉中度狭窄患者PSV、EDV参数低于颈动脉重度狭窄患者,组间差异具有统计学意义(P＜0.05).颈动脉重度狭窄患者PSV、EDV参数低于颈动脉中度狭窄患者,组间差异具有统计学意义(P＜0.05);收缩压(DBP)＞ 140 mmHg组患者眼动脉的PSV、EDV参数水平明显高于DBP≤140 mmHg组的患者,组间差异具有统计学意义(P＜0.05);ROC曲线分析显示,当EDV取值为9.52cm/s时缺血性脑血管疾病伴颈动脉狭窄的诊断敏感性为87.27％,特异性为46.15％,诊断价值优于PSV.结论 眼部血流动力学参数指标可以用来辅助诊断颈动脉狭窄型缺血性脑血管疾病,具有一定的临床使用价值.

Background: Double injection of blood into cisterna magna using a rabbit model results in cerebral vasospasm. An unacceptably high mortality rate tends to limit the application of model. Ultrasound guided puncture can provide real-time imaging guidance for operation. The aim of this paper is to establish a safe and effective rabbit model of cerebral vasospasm after subarachnoid hemorrhage with the assistance of ultrasound medical imaging.Methods: A total of 160 New Zealand white rabbits were randomly divided into four groups of 40 each: (1) manual control group, (2) manual model group, (3) ultrasound guided control group, and (4) ultrasound guided model group. The subarachnoid hemorrhage was intentionally caused by double injection of blood into their cisterna magna. Then, basilar artery diameters were measured using magnetic resonance angiography before modeling and 5 days after modeling.Results: The depth of needle entering into cisterna magna was determined during the process of ultrasound guided puncture. The mortality rates in manual control group and model group were 15 and 23 %, respectively. No rabbits were sacrificed in those two ultrasound guided groups. We found that the mortality rate in ultrasound guided groups decreased significantly compared to manual groups. Compared with diameters before modeling, the basilar artery diameters after modeling were significantly lower in manual and ultrasound guided model groups. The vasospasm aggravated and the proportion of severe vasospasms was greater in ultrasound guided model group than that of manual group. In manual model group, no vasospasm was found in 8 % of rabbits.Conclusions: The ultrasound guided double injection of blood into cisterna magna is a safe and effective rabbit model for treatment of cerebral vasospasm.

Objective To investigate the significance of ultrasonic performance of fetal ventricle anomalies in differential di?agnosis of abnormalities in central nervous system. Methods 92 cases of fetuses diagnosed with abnormalities in central nervous sys?tem were collected, all of whom underwent prenatal ultrasound examination in our hospital from January 2014 to May 2016. Ventricular abnormalities were retrospectively analyzed, and sonographic characteristics and associated deformity were summarized and analyzed. Results 92 fetuses cases with abnormalities in central nervous system were detected, consisting of 51 cases with absence of cavum septum pellucidum, 63 cases with lateral ventricle dilatation, 42 cases with the third ventricle dilatation, and 37 cases with the fourth ventricle dilatation. Conclusion Prenatal ultrasound can dynamically observe the development status of the central nervous system. Malformations in central nervous system can be diagnosed differentially by observing ventricle morphological changes.

1临床资料患者女性,63岁,农民,因"确诊纵隔型肺鳞癌19个月,发现左乳腺包块1周"于2015年7月8日入院。2013年11月在无明显诱因下出现咳嗽、胸闷、气喘症状,于2013年12月1日入住解放军第一〇五医院肿瘤三科,2013年12月2日在超声引导下给予纵隔肿块穿刺活检,2013年12月4日病理结果显示:鳞癌（图1A）;免疫组织化学结果显示:CD117阳性,CD5弱阳性,34βE12阳性,CK7阴性,CK20阴性,

患儿男,17岁,主因“左耳前包块10月余”入院.查体:左侧耳屏前方可触及约2.0 cm×1.0 cm包块,质硬,表面光滑,活动度差,无压痛.超声:左侧腮腺区1.62 cm×0.89 cm低回声包块,外形欠规则,边界清,内见少许钙化;CDFI可见较丰富血流信号(图1A、1B);弹性成像分级为Ⅳ级(图1C).

目的 探讨组织运动二尖瓣环位移自动追踪技术(TMAD)评价冠心病患者左心室收缩及舒张功能.方法 经冠状动脉造影证实的冠心病患者(CHD组)27例及年龄匹配的对照组30例,连续测量3个心动周期二尖瓣环4个位点的收缩期峰值位移(Ds)、瓣环连线中点最大位移(Mid)、Mid与左心室舒张期末最大纵径比值(Mid％)、收缩期达峰时间(T)、舒张早期位移(De)及舒张晚期位移(Da),求均值,计算Da/Dt(Dt=De+ Da),并将Ds均值、Mid均值、Mid％均值与双平面Simpson法计算出的左心室射血分数(LVEF)及将Da/Dt与二尖瓣口血流频谱A/E峰值比作相关性分析.结果 (1)与对照组相比,CHD组4个位点Ds、Mid、Mid％及其均值均降低(P＜0.01),4个位点达峰时间及其均值均延长(P＜0.05或P＜0.01);(2)与对照组相比,CHD组4个位点De及其均值均降低(P＜0.01),侧壁、前壁、下壁Da及4个位点Da均值均增高(P＜0.05或P＜0.01),Da/Dt增高(P＜0.01);(3)对照组、CHD组Ds均值、Mid均值及Mid％均值与LVEF呈正相关(对照组:r=0.697,r=0.711,r=0.779,P＜0.01;CHD组:r=0.707,r=0.703,r=0.789,P＜0.01);(4)对照组、CHD组Da/Dt与A/E峰值比呈正相关(r =0.739,r=0.666,P＜0.01).结论 TMAD新技术可以客观、方便地评价冠心病患者左心室功能.

Objective To observe the therapeutic effects,improvement of life quality,and toxic side effects of double-way chemotherapy combined with radiotherapy in the treatment of NSCLC patients with malignant pleural effusion.Methods 36 NSCLC patients with malignant pleural effusion were randomly and evenly divided into two groups according to the therapeutic method.The group A was treated with double-way chemotherapy combined with three-dimensional conformal radiotherapy,and the group B was treated with double road chemotherapy only.Besides,all of the patients were given routine and symptomatic treatment.The therapeutic effects,life quality and toxic side effects were evaluated and compared between the two groups.Results The effective rates were 94.4% and 61.1% respectively in the group A and the group B(P0.01).There was no significant difference of toxic side effects between the group A and the group B(P0.05).The Karnofsky score of the group A was higher than that of group B(P0.05).The overall survival of the group A was significantly longer than that of the group B(P0.05).Conclusion It is more effective for patients with malignant pleural effusion caused by NSCLC treated with double-way chemotherapy combined with three-dimensional conformal radiotherapy than double-way chemotherapy only.

Objective: To observe the influence of the respiration on cerebral venous outflow under different body position with color-coded duplex sonography. Methods: A total of 40 healthy volunteers were enrolled. Blood flow of internal jugular vein (IJV) and vertebral vein (VV) in quiet breath, deep inspiration and deep expiration were measured with Doppler at supine and sitting position. Results: At supine position, blood flow of IJV and VV accounted for 66.94% and 4.17% of total cerebral blood flow (tCBF) in quiet breath, respectively. In deep inspiration, the proportion of blood flow of IJV in tCBF increased to 86.61%, and of VV in tCBF decreased to 1.69%. There was no statistical difference between the volume of blood flow of IJV nor VV in deep expiration and quiet breath. At sitting position, the volume of blood flow of IJV and VV accounted for 18.08% and 14.73% of tCBF in quiet breath, respectively. In deep inspiration, the proportion of blood flow of IJV in tCBF increased to 89.68%, of VV in tCBF decreased to 1.86%. There was neither statistical difference between the volume of blood flow of IJV nor VV in deep expiration and quiet breath. Conclusion: The proportion the blood flow of IJV in tCBF increases significantly in forced breathing both at supine and sitting position.

目的 通过对不同体位下左右两侧颈内静脉的彩色多普勒超声对照观察.为颈清术中是否应该保留颈内静脉提供理论依据.方法 选取40例青年健康志愿者.受检者平静呼吸.采用彩超观测左右两侧颈内静脉在卧位和坐位下的血流动力学参数变化情况.结果 卧位时,右侧颈内静脉横截面积、血流速度和血流量分别比左侧大58%、23%和91%,差异具有统计学意义;26例(65%)患者颈内静脉为右优势型,10例(25%)为对称型,4例(10%)为左优势型;颈内静脉血流总量占脑总血流量的74%,其中29例(72%)受检者为颈内静脉优势型,9例(22%)为均衡型,2例(5%)为其他静脉优势型.坐位时,右侧颈内静脉横截面积、血流速度和血流量分别比左侧大29%、35%和56%,其中血流速度和血流量的差异具有统计学意义;18例(45%)患者颈内静脉为右优势型,18例(45%)为对称型,4例(10%)为左优势型;颈内静脉血流总量占脑总血流量的23%,其中无颈内静脉优势型,9例(22%)为均衡型,31例(77%)为其他静脉优势型.结论 左右两侧颈内静脉存在不对称性,坐位时,颈内静脉并非颅内静脉的主要颅外回流通道.术前彩色多普勒超声检查能够为颈清术手术方式的选择提供依据.

Objective To observe the blood flow of internal jugular vein(IJV) and vertebral vein(VV) under different body positions with color-coded duplex sonography,in order to clarity the cerebral venous outflow under different body positions.Methods A total of 40 healthy youngand middle-aged volunteers were enrolled.The hemodynamic data such as section area,velocity,and volume of blood flow patients were measured by Doppler under supine and sitting position in eupnoea.Results In supine position,the section area of IJV was(0.67±0.26)cm2,the velocity was(18.73±7.37)cm/s,and the volume of blood flow was(758.51±437.23)ml/min,while the section area of VV was(0.04±0.02)cm2,the velocity was(19.25±8.88)cm/s and the volume of blood flow was(47.23±25.40)ml/min.The proportion of IJV flow volume in total cerebral venous outflow(the sum of IJV flow volume and VV flow volume) was 94.13%.In sitting position,the section area of IJV was(0.16±0.09)cm2,the velocity was(18.08±10.71)cm/s and the volume of blood flow was(177.43±157.42)ml/min,while the section area of VV(0.06±0.03)cm2,the velocity was(36.06±16.88)cm/s and the volume of blood flow was(144.61±94.97)ml/min.The proportion of IJV flow volume in total cerebral venous outflow was 22.02%.Compared with the results in supine and sitting position,the section area and volume of blood flow of IJV decreased significantly,the section area,velocity,and volume of blood flow of VV increased significantly(all P0.01).Conclusion In healthy volunteers under quiet condition,IJV and vertebral venous system are the main paths of the outflow of cerebral venous system in supine position and sitting position,respectively.

Aim To further evaluate the clinical value and methodology of ultrasound-guided percutaneous lung biopsy and to explore the ways to reduce complications and improve the positive rate of derived results.Methods 978 cases of lung imaging demonstrated a clear need to peripheral tumor diagnosed by ultrasound guided percutaneous lung biopsy.Results 937 cases were confirmed in the 978 cases with a confirmed biopsy rate of 95.8%.The outcomes of pathological diagnosis were listed as follows:714 cases of malignant tumor,including squamous carcinoma(n=306),adenocarcinoma(n=215),anaplastic carcinoma(n=118),malignant lymphoma(n=4),and malignant mesothelioma(n=3),alveolar carcinoma(n=30),metastatic carcinoma(n=23),other malignant tumor(n=15),223 cases of benign lesion,including tuberculosis(n=82).lung abscess(n=35),inflammatory pseudotumor(n=101),hamartoma(n=5).41 cases were not diagnosed.Complication rate was 2.15%,including 13 cases of pneumothorax and 8 cases of hemoptysis.Conclusion Ultrasound guided percutaneous lung biopsy is safe and offers a high diagnostic rate,especially suitable for the pulmonary peripheral masses.