高回声肾错构瘤的超声造影表现  

The performance of hyperechoic renal angiomyolipoma on contrast-enhanced ultrasonography

作　　者：黄备建[1] 李超伦[1] 徐本华[1] 陆清[1] 李丛[1] 王文平[1] 

机构地区：[1]上海复旦大学附属中山医院超声诊断科,200032

出　　处：《上海医学影像》2009年第4期283-284,291,共3页Shanghai Medical Imaging

基　　金：上海市重点学科建设项目(项目编号:B112);上海市卫生局课题(项目编号:2008190)

摘　　要：目的探讨超声造影在高回声肾错构瘤中的表现。方法对24例24个经手术病理证实的高回声肾错构瘤常规超声及超声造影声像图进行回顾性分析。常规超声观察肾占位大小、回声、边界、有无彩色血流信号。超声造影观察病灶的增强时相和方式,包括起始时间、达峰值时间、消退时间及病灶内部结构的增强表现。结果常规超声显示24个肿块最大直径范围1.7cm～28.0cm,实质回声团块23个,实质为主的囊实性回声1个;12个肿块发现较丰富或丰富彩色血流信号,10个显示周边或内部少量血流信号,2例未见血流信号;术前常规超声诊断符合率为75%(18/24)。超声造影时24个肿块平均增强起始时间为(14.42±4.06)s,达峰时间为(21.63±5.01)s,开始消退时间(31.29±6.80)s。皮质期21个病灶呈缓慢向心增强,3个同步增强;达峰值呈高增强7个,等增强8个,低增强9个,其中20例均匀增强;实质期同步消退7个,缓慢消退11个,快速消退6个。皮质期缓慢向心增强和达峰值均匀增强共有特征的诊断符合率为83.3%(20/24)。结论超声造影有助于高回声肾错构瘤的诊断。Objective To investigate the features of hyperechoic renal angiomyolipoma（AML） on contrast-enhanced ultrasonography（CEUS）.Methods The images of conventional Ultrasound（US） and CEUS were retrospectively analyzed in 24 renal AMLs which were confirmed by operation and pathology.The size,inner echo,boundary and color flow signals of renal lesions were observed by conventional US.Then the modality and phases of enhancement were also observed by CEUS,including the arrival time,the peak time,the washout time and the appearance of internal structures.Results The maximum diameter range of 24 renal lesions was from 1.7cm to 28.0cm.On conventional US,tumors were displayed 23 solid masses and 1 solid-cystic mass.The color Doppler flow imaging（CDFI） disclosed rich or relatively rich flow signals in 12 cases,a small amount of flow signals in 10 cases and non-flow signal in 2 cases.The diagnostic accuracy was 75%（18/24） before operation.All lesions were showed mean enhancement start time 14.42±4.06 seconds,peak time 21.63±5.01 seconds,wash-out time 31.29±6.80 seconds respectively on CEUS.In cortical phase,CEUS detected the delayed centripetal enhancement in 21 cases and synchronously enhancement in 3 cases.In peak time,hypervascular,isovascular and hypovascular enhancement compared to the normal renal cortex were detected in 7 cases,8 cases and 9 cases respectively.The homogeneous enhancemen was displayed in 20 lesions.In parenchymal phase,CEUS showed isochronous washout in 7 cases,delayed washout in 11 cases and fast washout in 6 cases.The diagnostic accuracy was 83.3%（20/24）by combining delayed enhancement in cortical phase with homogeneous enhancement in peak time on CEUS.Conclusion CEUS may play an important role in diagnosing hyperechoic renal AML.

关 键 词：超声造影 肾错构瘤 诊断 

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