超声造影对多房囊性肾细胞癌的诊断价值  

Diagnostic Value of Contrast Enhanced Ultrasound for Multilocular Cystic Renal Cell Carcinoma

作　　者：李丛[1] 黄备建[1] 王文平[1] 薛立云[1] 严丽霞[1] 

机构地区：[1]复旦大学附属中山医院超声科,上海200032

出　　处：《中国临床医学》2013年第5期662-664,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨利用超声造影(contrast enhanced ultrasound,CEUS)Bosniak分级诊断多房囊性肾细胞癌(multilocular cystic renal cell carcinoma,MCRCC)的可行性及其价值。方法:选取2004年7月—2011年12月在复旦大学附属中山医院行CEUS并最终经手术病理证实为MCRCC的患者14例(共14个病灶),采用CEUS Bosniak分级分析肿瘤的分隔数目、厚度、实质成分以及血供情况。结果:14例MCRCC患者的病灶常规超声图均表现为"蜂窝状"的多房囊性占位,其中5例可见部分实质成分,9例可检测出彩色多普勒血流信号。CEUS声像图显示,14例病灶均可见皮质期增强,平均增强起始时间(14.57±3.15)s,平均达峰值时间(20.21±4.24)s,平均减退时间(29.28±3.98)s。CEUS声像图显示,10例病灶表现为同步增强快速减退,3例同步增强同步减退,1例缓慢增强快速减退。达峰值强度8例表现为高回声,3例等回声,3例低回声。CEUS声像图Bosniak分级:Ⅰ-Ⅱ级(0例),ⅡF级(3例),Ⅲ级(6例),Ⅳ级(5例)。CEUS声像图显示,6例(6/14,42.86%)病灶较常规超声显示分隔数目更多,3例(3/14,21.43%)病灶较常规超声显示分隔厚度更厚。结论:CEUS较常规超声更能清晰显示MCRCC的血供和内部结构,有助于MCRCC的诊断。Objective：To analyze the feasibility and the diagnostic value of contrast enhanced ultrasound （CEUS） based on Bosniak classification system for multilocular cystic renal cell carcinoma （MCRCC）.Methods：A total of 14 pathologically confirmed MCRCC patients （14 nidus） selected during July 2004 to December 2011 were retrospecively analyzed for septa number and thickness,solid components and blood supply situation by the CEUS Bosniak classification.Results：On conventional US images,all tumors in 14 MCRCC patients appeared as well-defined multilocular cystic masses composed of serous or complicated fluid.Moreover,solid component was detected in 5 lesions,and color Doppler blood flow signals were detected in 9 cases by conventional US.On CEUS images,all lesions showed enhancement in the cortical phase.The mean enhancement start time,peak time and wash-out time were （14.57 ± 3.15） s,（20.21 ± 4.24） s and （29.28 ± 3.98） s,respectively.Ten lesions of the common enhancement pattern were simultaneous wash-in and rapidly wash-out,3 cases simultaneous wash-in and wash-out,1 case slowly wash-in and rapidly wash-out.In peak time,hyperechogenicity compared to the normal renal cortex was showed in 8 tumors,hypoechogenicity in 3 tumors and isoechogenicity in 3 tumors.These lesions were categorized by CEUS based on Bosniak classification system as follows：category Ⅰ-Ⅱ （n =0）,category Ⅱ F （n=3）,category Ⅲ （n=6）,and category Ⅳ （n =5）.CEUS images showed more septas in6 （6/14,42.86％） lesions,more thickened walls in 3 （3/14,21.43 ％） lesions.Conclusions：CEUS shows blood supply and internal structures of MCRCC better than conventional imaging,which is useful for MCRCC diagnosis.

关 键 词：超声造影 多房囊性肾细胞癌 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]