超声造影对肾脏良恶性肿瘤的鉴别诊断价值  

The Differential Diagnosis Value of Benign and Malignant Renal Masses with Contrast-enhanced Ultrasound

作　　者：顾继英[1] 杜联芳[1] 李凡[1] 姜露莹[1] 杨亚汝[1] 邢晋放[1] 

机构地区：[1]上海交通大学医学院附属第一人民医院超声科,上海市200080

出　　处：《中国超声医学杂志》2008年第11期1017-1020,共4页Chinese Journal of Ultrasound in Medicine

基　　金：上海市科委自然基金资助(No:05ZR14087)

摘　　要：目的初步探讨超声造影对肾脏良恶性肿瘤的鉴别诊断价值。方法对35例肾脏肿瘤患者术前常规二维及彩色多普勒超声检查后,即行超声造影检查,观察造影剂开始显影、达峰及消退的全过程,利用ACQ软件得时间-强度曲线数值。结果肾细胞癌27例,肾血管平滑肌脂肪瘤8例,彩色多普勒超声诊断准确率是88.6%(31/35),使用超声造影后准确率提高到97.1%(34/35),敏感性为100%,特异性87.5%。肾细胞癌造影模式以快进慢退高增强为主(20/27),即富血供型,少数呈低增强(7/27),即乏血供型;肾血管平滑肌脂肪瘤部分为慢进慢出(5/8),部分为快进慢出(3/8),增强强度不一,大多数为均匀性增强。结论超声造影对肾脏肿瘤的诊断提供了更多的信息,提高了诊断准确性,对良恶性的鉴别有重要价值。Objective To initial study the differential diagnosis value of benign and malignant renal masses with contrast-enhanced ultrasound.Methods 35 cases of renal masses were examined by two-dimensional and color Doppler ultrasonography before operation.Following the contrast-enhanced ultrasound,we observed the beginning of contrast agent enhancement,the peak and the dissipation as a whole.Results There were 27 cases of renal cell carcinoma and 8 cases of Renal angiomyolipoma.The diagnostic rate of color Doppler ultrasonography was 85.7%（30/35）,the accuracy rate improved to 94.3%（33/35） after the contrast agent,the sensibility was 100% and the specificity was 87.5%.The contrast-enhanced ultrasound of renal cell carcinoma showed a ＂fast-in and slowly-out and high enhance＂ mostly,that is the hypervascular pattern,the few hypovascular pattern showed low enhance.A part of Renal angiomyolipoma showed a ＂slowly-in and showly-out＂,the other part showed a ＂fast-in and showly-out＂.The enhance intensity were not same and mostly uniform.Conclusions Ultrasound contrast provided more informations to the diagnosis of renal masses,improved the diagnostic accuracy,had important value in benign and malignant identification diagnosis.

关 键 词：肾脏肿瘤 超声造影 鉴别诊断 临床分析 

分 类 号：R737.11[医药卫生—肿瘤] R735.704[医药卫生—临床医学]