肾恶性占位性病变的Sonazoid超声造影和增强CT增强特征的对比研究  

Comparative study of the enhancement characteristics of CEUS with Sonazoid and CECT in malignant renal space-occupying lesions

作　　者：土继政[1] 张少飞 梁华 张凯[1] 王博娟 朱丽静 郝磊 王兴华[1] TU Ji-zheng;ZHANG Shao-fei;LIANG Hua;ZHANG Kai;WANG Bo-juan;ZHU Li-jing;HAO Lei;WANG Xing-hua(Department of Ultrasound,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China;Shanxi Medical University,School of Medical Imaging,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院超声科,山西太原030001 [2]山西医科大学医学影像学院,山西太原030001

出　　处：《中国临床医学影像杂志》2022年第11期788-793,共6页Journal of China Clinic Medical Imaging

基　　金：山西省科技厅重点研发计划项目(编号:201703D421029)

摘　　要：目的:对比研究肾恶性占位性病变的Sonazoid超声造影(Sonazoid-CEUS)和增强CT(CECT)的增强特征,比较两种检查方法的优劣势,提高对肾恶性占位性病变的诊断效能。方法:选取病理学确诊的30例肾恶性占位性病变患者共32个病灶为研究对象,分别行Sonazoid-CEUS和CECT检查,比较两种方法的病灶峰值增强程度、增强形态分级及增强模式,其中增强形态分级分为1~4级:1级:周边细线样增强;2级:周边不规则厚环形增强;3级:整体不均匀增强;4级:均匀弥漫增强。结果:(1)肾透明细胞癌(ccRCC)的Sonazoid-CEUS和CECT增强特征比较:28个ccRCC的Sonazoid-CEUS始增时间均<30 s,CECT从30 s开始断层扫描,无法获得病灶准确的始增时间点;26个ccRCC的Sonazoid-CEUS和CECT峰值增强程度均多呈富血供表现,差异无统计学意义(P>0.05);28个ccRCC的Sonazoid-CEUS增强形态为4级病灶的比例明显高于CECT,差异有统计学意义(P<0.05);26个ccRCC的Sonazoid-CEUS和CECT增强模式均多呈快进快退,差异无统计学意义(P>0.05)。(2)肾盂尿路上皮癌(RPUC)的Sonazoid-CEUS和CECT增强特征比较:4个RPUC的Sonazoid-CEUS始增时间均<30 s,3个RPUC的SonazoidCEUS峰值增强程度呈富血供(2个)和乏血供(1个),4个RPUC的CECT峰值增强程度均呈乏血供表现。结论:Sonazoid-CEUS和CECT均能有效显示肾恶性占位性病变的血流灌注特点且优势互补,熟练掌握两种方法的增强特征可提高对肾恶性占位性病变的诊断效能。Objective:The enhancement characteristics,advantages,and disadvantages were compared between contrast-enhanced ultrasonography with Sonazoid(Sonazoid-CEUS)and contrast-enhanced computed tomography(CECT)in malignant renal space-occupying lesions,in order to improve the diagnostic efficiency of malignant renal space-occupying lesions.Methods:A total of 32 lesions in 30 patients with malignant renal space-occupying lesions confirmed by pathology were included.Son-azoid-CEUS and CECT were performed respectively.The peak enhancement degree,enhancement morphological grading and enhancement mode of the two methods were compared.The enhancement morphology is divided into four grades:Grade 1,pe-ripheral thin-line enhancement.Grade 2,peripheral irregular thick-ring enhancement.Grade 3:total inhomogeneous enhance-ment.Grade 4:diffuse homogeneous enhancement.Results:(1)Comparison of the enhancement characteristics between Sonazoid-CEUS and CECT in clear cell renal cell carcinoma(ccRCC).The arrive time of Sonazoid-CEUS in 28 ccRCCs were less than 30 s.The arrive time of CECT could not be obtained accurately because the starting scan was from 30 s.The peak en-hancement degree of Sonazoid-CEUS and CECT in 26 ccRCCs were mostly hypervascular.There were no stastistiacally signif-icant differeces(P>0.05).The proportion of grade 4 lesions in Sonazoid-CEUS in 28 ccRCCs was significantly higher than that in CECT(P<0.05).The enhancement patterns of Sonazoid-CEUS and CECT in 26 ccRCCs were mostly rapid wash-in and rapid wash-out.There were no stastistiacally significant differeces(P>0.05).(2)Comparison of the enhancement characteristics between Sonazoid-CEUS and CECT in renal pelvic urothelial carcinoma(RPUC):The arrival time of Sonazoid-CEUS in four RPUC were less than 30 s.The peak enhancement degree of Sonazoid-CEUS in three RPUC were hypervascular in two and hypovascular in one.The peak enhancement degree of CECT in four RPUC were hypovascular.Conclusion:Sonazoid-CEUS and CECT can effectively display the blood perfusion characteris

关 键 词：肾肿瘤 超声检查 多普勒 彩色 体层摄影术 X线计算机 血管造影术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.11[医药卫生—诊断学] R730.44[医药卫生—临床医学]