超声造影、增强CT及增强MRI对肾脏占位性病变的诊断价值比较  

Comparison of Contrast-enhanced Ultrasound,Contrast-enhanced CT and Contrast-enhanced MRI in the Diagnosis of Renal Space-occupying Lesions

作　　者：张智 赵子卓[2] 阮镜良[2] 田晶[2] 罗葆明[2] 

机构地区：[1]广州市老人院超声科,广东广州510550 [2]中山大学孙逸仙纪念医院超声科,广东广州510120

出　　处：《中国医学影像学杂志》2014年第10期764-767,共4页Chinese Journal of Medical Imaging

摘　　要：目的比较超声造影、增强CT及增强MRI对肾脏占位性病变的诊断价值。资料与方法对78例经常规超声诊断为肾脏占位性病变患者的80个病灶进行实时超声造影检查,39个行增强CT检查,28个行增强MRI检查,其中5个同时行增强CT及增强MRI检查。以病理结果为"金标准",比较超声造影、增强CT及增强MRI诊断肾脏占位性病变良恶性的价值。结果 80个病灶中,57个为恶性病变,23个为良性病变;超声造影诊断肾脏病变良恶性的敏感度、特异度、阳性预测值、阴性预测值分别为93.0%、69.6%、88.3%、80.0%;增强CT诊断肾脏病变良恶性的敏感度、特异度、阳性预测值、阴性预测值分别为96.4%、72.7%、90.0%、88.9%;增强MRI诊断肾脏病变良恶性的敏感度、特异度、阳性预测值、阴性预测值分别为86.4%、66.7%、90.5%、57.1%;3种检查诊断效果间差异无统计学意义(P>0.05)。结论超声造影、增强CT及增强MRI对于肾脏占位性病变良恶性的诊断效果相当,临床可以根据各个检查技术的特点,为不同的患者选择适宜的检查,联合应用两种检查方法为肾脏占位性病变的诊断提供了更丰富的信息。Purpose To compare the value of contrast-enhanced ultrasound（CEUS）, contrast-enhanced CT（CECT） and contrast-enhanced MRI（CEMRI） in the diagnosis of renal space-occupying lesions. Materials and Methods Seventy-eight patients whose 80 kidney space-occupying lesions were confirmed by traditional ultrasound underwent CEUS examination. Among those patients, 39 patients also underwent CECT, 28 had CEMRI, and 5 had CECT and CEMRI examination together. Taken pathologic findings as gold standard, the value of conventional ultrasound, CEUS, CECT and CEMRI was compared in the diagnosis of renal space-occupying lesions. Results Among 80 renal masses, 57 lesions were malignant and the rest 23 lesions were benign. The diagnostic sensitivity, specificity, positive predictive value and negative predictive value were 93.0%, 69.6%, 88.3%, 80.0% for CEUS; those for CECT were 96.4%, 72.7%, 90.0%, 88.9% respectively; and for CEMRI were 86.4%, 66.7%, 90.5%, 57.1% respectively; and the diagnostic value among the three means showed no difference（P〉0.05）. Conclusion CEUS, CECT and CEMRI are all effective in the diagnosis of renal space-occupying lesions, We may select suitable examination means for patients according to their features. A combination of these techniques provides more information for the diagnosis of renal space-occupying lesions.

关 键 词：肾疾病 超声检查 多普勒 彩色 造影剂 体层摄影术 螺旋计算机 磁共振成像 图像增强 病理学 外科 

分 类 号：R737.11[医药卫生—肿瘤] R730.4[医药卫生—临床医学]