低机械指数实时超声造影对肾良恶性肿瘤诊断的临床价值  

Clinical value of real time contrast-enhanced ultrasound with low mechanical index in diagnosis of renal tumor

作　　者：刘学会[1] 聂芳[1] 王小锋[1] 贾英英[1] 耿祥亮 李燕[1] 

机构地区：[1]兰州大学第二医院超声科,甘肃兰州730030

出　　处：《兰州大学学报（医学版）》2015年第3期53-57,共5页Journal of Lanzhou University（Medical Sciences）

基　　金：甘肃省科技支撑项目(144FKCA061)

摘　　要：目的评估低机械指数实时超声造影在肾局灶性病变诊断中的临床价值。方法 32例肾占位性病变患者进行超声造影检查,观察造影增强的时间、增强水平,将病灶分为富血供、乏血供和无血供。手术切除肾实质肿瘤经病理诊断证实其良恶性,与增强CT检查结果进行对比分析。结果肾透明细胞癌富血供为91%,乏血供为9%;乳头状肾细胞癌富血供为50%,乏血供为50%;嫌色细胞癌乏血供为100%,浸润性尿路上皮癌富血供为100%,血管平滑肌脂肪瘤富血供为100%。32例患者中,3例增强CT未能显示增强,而超声造影显示所有病灶均可见造影剂进入,对>5 cm病灶的血流量检测差异有统计学意义(P<0.05)。结论超声造影能很好地反应肿瘤的血供情况,与增强CT相比,对乏血供肾肿瘤的检测更具敏感性。Objective To evaluate the clinical value of real time contrast-enhanced ultrasound with low mecha-nical index in diagnosis of renal focal lesions. Methods Thirty-two patients with focal tumors underwent examination by gray scale ultrasonography, the lesions were divided into the rich blood supply, lack of blood supply and no blood supply according to the contrast enhanced time and level. Underwent resection for sus-pected renal malignancy, observating time, enhanced-contrast level and dividing lesions into. The diagnosis of surgically removed renal parenchyma tumor was confirmed by pathological examination, analyze the results compared to the findings of enhanced CT. Results Renal clear cell carcinoma with rich blood supply was 91%, lacking of blood supply was 9%;Papillary renal cell carcinoma withrich blood supply was 50%, lack-ing of blood supply is 50%;100%color cell carcinoma lacked of blood supply, all of invasive urothelial carci-noma was rich blood supply, for angiomyolipomas, rich blood supply was 100%. Enhanced CT failed to show enhancement in 3 cases among 32 cases, contrast agent was visible in ultrasonic imaging of all lesion-sand, and also remarkably distinguishable for〉5 cm focus （P〈0.05）. Conclusion Ultrasonic imaging can well reflect blood supply of tumors, is more sensitive in detection of renal tumors lacking of blood compar-ing with enhanced CT.

关 键 词：增强CT 超声造影 肾疾病 肿瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学]