不同类型肾脏占位病变的超声造影特征及其诊断价值探讨  

Characteristics and diagnostic value of contrast enhanced ultrasonography in various kidney space occupying lesions

作　　者：程力 

机构地区：[1]英山县人民医院超声科,湖北438700

出　　处：《放射学实践》2016年第1期89-92,共4页Radiologic Practice

摘　　要：目的:探讨不同类型肾脏占位病变的超声造影特征及其诊断价值。方法:搜集肾脏占位病变手术患者100例,术前均行超声造影检查,根据手术病理结果将病变分为恶性病变(肾癌41例、肾盂癌19例)和良性病变(肾错构癌29例、肾囊肿11例),分析不同类型病变超声造影特征。结果:肾癌、肾盂癌以快进快出型或快进慢出型为主,错构瘤以慢进慢出型为主,而肾囊肿以平台型为主,不同类型肾脏占位病变的超声造影增强模式差异有统计学意义(P<0.05)。根据时间-信号强度曲线采集相关参数,肾癌、肾盂癌峰值强度、曲线尖度、曲线下面积均明显高于肾错构癌、肾囊肿,达峰时间明显低于肾错构癌、肾囊肿,差异均有统计学意义(P<0.05)。超声造影对肾脏占位性病变良恶性的鉴别诊断灵敏度、特异度、阳性预测值、阴性预测值和准确度分别为75.00%、62.50%、75.00%、62.50%和70.00%。结论:不同类型肾脏占位病变的超声造影增强模式及时间-信号强度曲线差异显著,超声造影对肾脏占位病变良恶性的鉴别诊断灵敏度和阳性预测值较高。Objective：To study the characteristics and diagnostic value of contrast enhanced ultrasonography （CEUS） in various kidney space occupying lesions. Methods： 100 patients with surgery and pathology proved kidney space occupying lesion were recruited. All of these patients had CEUS before surgery. According to the pathology,lesions were classified as malignant renal carcinoma, 41 cases ; renal pelvic carcinoma, 19 cases） and benign （renal hamartoma, 29 cases ; renal cyst, 11 cases）. The CEUS patterns of these various renal space occupying lesions were analyzed. Results：The CEUS pattern of renal carcinoma and renal pelvic carcinoma were mainly as ＂fast-in-fast-out type＂ or ＂fast-in-slow-out type＂;of renal hamartoma was mainly ＂slow-in-slow-out type＂; and of renal cyst was mainly as ＂platform type＂ , with statistically significant difference （P〈0.05）. According to the parameters of time signal intensity curve, the peak intensity, curve peak and area below the curve of renal carcinoma and renal pelvic carcinoma were significantly higher than that of renal hamartoma and renal cyst; but the peak time was significantly lower than that of renal harmatoma and renal cyst, with significant difference （P〈0. 05）. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CEUS for the differen- tial diagnosis of benign and malignant renal space occupying lesions were 75.00% ,62.50% ,75.00% ,62. 50% and 70.00% respectively. Conclusion：The contrast-enhanced ultrasonographic patterns and time signal intensity curve varied significantly in different renal space occupying lesions. The sensitivity and positive predictive value of contrast-enhanced ultrasonography is high in the differential diagnosis of benign or malignant renal space occupying lesions.

关 键 词：肾脏占位病变 超声造影 诊断 鉴别 时间-信号强度曲线 

分 类 号：R737.11[医药卫生—肿瘤] R445.1[医药卫生—临床医学]