超声造影与增强CT诊断肾细胞癌的比较研究  

A comparison study of contrast-enhanced ultrasonography and contrast-enhanced computed-tomography in the diagnosis of renal cell carcinoma

作　　者：王飞[1] 戴宇平[1] 万广生[2] 梁月有[1] 邓春华[1] 郭燕[3] 

机构地区：[1]中山大学附属第一医院泌尿外科,广州510080 [2]中山大学附属第一医院超声科 [3]中山大学附属第一医院放射科

出　　处：《临床泌尿外科杂志》2008年第1期18-21,共4页Journal of Clinical Urology

摘　　要：目的:比较研究SonoVue超声造影(CEUS)和增强CT(CECT)在肾细胞癌诊断中的应用价值。方法:对56例肾占位性病变行SonoVue超声造影检查(CEUS组),同时对其中53例行增强CT检查(CECT组)。连续、实时、动态观测肾肿瘤及周边肾实质血流灌注情况,记录注射造影剂后皮质期、实质期及延迟期肿瘤增强形态、强化方式,并与CECT增强全过程相比较。结果:CEUS组癌灶增强主要表现为皮质期等增强,实质期、延迟期低或等增强,仅有少部分表现为三期轻微增强。确诊肾恶性肿瘤42例,误诊4例;确诊良性肿瘤7例,误诊3例。CECT组确诊肾恶性肿瘤38例,误诊5例;确诊良性肿瘤6例,误诊4例。CEUS和CECT诊断肾恶性肿瘤的灵敏度、阳性预测价值、诊断准确率分别为91.3%/88.4%、93.3%/88.4%、87.5%/81.1%。结论:CEUS和CECT都能敏感显示肾细胞癌血供强化特征,在肾细胞癌的定性诊断中起到相互补充的作用。Objective：To explore and compare the value of contrast-enhanced ultrasonography and contrast-enhanced computed-tomography in the diagnosis of renal cell carcinoma. Methods：We performed CEUS,CECT examination on 56,53 patients with renal neoplasms respectively. The blood perfusion condition of the masses and surronding normal renal parenchyma in a continuous and dynamic way were observed and the enhancement appearnce and patterns of neoplasms in cortical, parenchymal and delayed phase of CEUS were compared with that of CECT. Results： The majority of RCC showed moderate enhancement in cortical phase, slight enhancement in parenchymal, delayed phase,only a small part showed slight enhancement in three phases. Correct diagnoses were obtained in 42 malignant and 7 benign masses by CEUS, while 38 malignant and 6 benign masses by CECT. There were only 4 malignant and 3 benign cases were misdiagnosed by CEUS while 5 malignant and 6 benign masses by CECT. The diagnostic performance of CEUS and CECT in characterrization of renal tumors were as follows： sensitivity 91.3%/88.4%, positive predictive value 91.3%/88.4%, diagnostic accuracy 87.5%/81.1%. Conclusions：CEUS can display the blood supply feature of renal neoplasms sensitively as CECT and play a complementary role in the diagnosis of renal cell carcinoma.

关 键 词：超声显像 增强X线电子计算机断层扫描 肾细胞癌 

分 类 号：R699.1[医药卫生—泌尿科学]