超声造影和增强CT诊断肾盂癌的比较研究  

Comparative study of renal pelvic carcinoma by contrast-enhanced ultrasonography and contrast-enhanced computed tomography

作　　者：王晓[1] 黄备建[1] 李丛[1] 燕翠菊[1] 范培丽[1] 李超伦[1] 王文平[1] 

机构地区：[1]复旦大学附属中山医院超声诊断科,上海200032

出　　处：《中华超声影像学杂志》2012年第8期687-690,共4页Chinese Journal of Ultrasonography

基　　金：上海市重点学科建设项目资助（B112）;卫生部公益性行业科研专项经费项目（200802-10）

摘　　要：目的对比分析超声造影和增强CT显示肾盂癌血流灌注特点的异同点，探讨超声造影的临床应用价值。方法对40例行超声造影和增强CT检查并经手术病理证实的肾盂癌病例进行回顾性分析，观察肿块的增强时相和增强方式，包括肿块的增强、消退时间和灌注表现。结果超声造影显示皮质期40个肿块全部增强；同步增强14个，缓慢增强26个；达峰值呈低回声31个，高回声4个，等回声5个；实质期快速消退35个，同步消退2个，缓慢消退3个；显示最小病灶为1．5cm。增强CT显示38个肿块增强，多呈轻、中度均匀强化，增强程度低于周围肾实质。超声造影诊断准确率为77．5％（31／40），增强CT诊断准确率为82．5％（33／40），两者比较差异无统计学意义（P〉0．05）。结论超声造影和增强CT对。肾盂癌均有较高的诊断准确率，联合检测可提高早期诊断的检出率。Objective To compare and analyze the similarities and differences of the blood perfusion characteristics of the renal pelvic carcinoma displayed by contrast-enhanced ultrasonography（CEUS） and contrast-enhanced computed tomography（CECT）. Methods The characteristics of CEUS and CECT were anzlyzed retrospectively in 40 confirmed renal pelvic carcinoma cases by operation and pathology. The modality and phases of enhancement, including wash-in and washout time, as well as the perfusion appearances, were observed by CEUS and CECT. Results CEUS detected the cortical phase enhancement in all renal pelvic tumors, including synchronously enhancement in 14 tumors and delayed enhancement in 26 tumors. At peak times, hypoechogenicity compared to the normal renal cortex was shown in 31 tumors, hyperechogenicity in 4 tumors and isoeehogenicity in 5 tumors. Fast wash-out in medulla phase was displayed in 35 tumors, isochronously wash-out in 2 tumors and delayed wash-out in 3 tumors. The minimum diameter in 40 renal pelvic tumors was 1.5 cm. CECT showed the enhancement in 38 tumors, mostly mild to moderate homogeneous enhancement, and enhancement was lower than the surrounding renal parenchyma. The diagnostic accuracy of CEUS was 77.5%（31/40）, and the diagnostic accuracy of CECT was 82.5 % （33/40）. The difference was not statistically significant between CEUS and CECT （ P 〉0.05）. Conclusions CEUS and CECT have higher diagnostic accuracy of the renal pelvic carcinoma, so the joint detection can increase the detection rate of early diagnosis of the renal pelvic carcinoma.

关 键 词：超声检查 微气泡 肾盂肿瘤 体层摄影术 X线计算机 

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]