实时超声造影在肾脏占位性病变诊断中的应用价值  

Diagnosis value of renal occupying leision by real-time contrast-enhanced ultrasound

作　　者：郭君[1] 王敏娜[1] 梁媛[1] 王新楠[1] 

机构地区：[1]航天中心医院超声科,北京100049

出　　处：《中华医学超声杂志（电子版）》2010年第9期42-44,共3页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨实时超声造影在肾脏占位性病变诊断中的应用价值。方法对85例肾脏占位性病变,采用造影剂声诺维(SonoVue)及反向脉冲谐波技术进行实时超声造影,观察肾占位病变区造影剂的灌注过程及造影后声像图特点。结果 39例肾脏恶性病变中94.9%表现为造影剂早于自身肾皮质或与肾皮质同步快速充填;61.5%表现为造影剂早于自身肾皮质或与肾皮质同步廓清,即为"快进或快出"。28例错构瘤有50.0%病例表现为缓慢增强;64.0%缓慢廓清,称作"慢进慢出"。这两类病变在造影增强模式上具有明显差异。18例肾囊肿表现为造影剂灌注缺如区周边清晰光滑,囊肿内无造影剂或仅见分隔上少量血流信号。超声造影前后超声诊断准确率分别为73.0%(62/85)与92.9%(79/85)。结论实时超声造影可显著提高肾良恶性占位性病变超声诊断的准确性,对鉴别诊断具有重要的临床应用价值。Objective To investigate the application value of real-time contrast-enhanced ultrasond in the diagnosis of kidney occupying lesions.Methods To assess the contrast agent infusion process and post-contrast sonographic features of the renal occupying lesion by using contrast agent SonoVue and inverse pulse technique in 85 patients with renal occupying lesions.Results Of all,94.9% of the 39 renal malignant lesions showed contrast agent rapid filling,earlier than or synchronized with the renal cortex;61.5% showed clearance earlier than or synchronized with the renal cortex,which was ＂fast wash-in and fast wash-off＂.Twenty-eight cases of hamartomas showed slow enhancement;64.3% showed slow clearance,which was ＂slow wash-in and slow wash-off＂.There was a significant difference for two types of lesions in the contrast-enhanced models.Renal cysts showed absence of the contrast agent with clear and smooth margin,or only a small amount of blood flow on the septum;Hydronephrosis showed expansion of renal pelvis having clear border without enhancement.The sensitivity of sonographic contrast-enhanced imaging was found in 92.9%（79 /85） of subjects compared with 73.0%（62 /85） of conventional sonography.Conclusion The real-time contrast-enhanced ultrasound can improve the diagnostic accuracy of renal occupying leisions,which is valuable in the differential diagnosis between benign and malignant renal leisions.

关 键 词：超声检查 造影剂 肾脏占位性病变 

分 类 号：R445.1[医药卫生—影像医学与核医学]