多房囊性肾瘤和多房囊性肾癌的超声造影鉴别诊断  

The Differential Diagnosis is of Multilocular Cystic Nephroma and Multilocular Cystic Renal Cell Carcinoma with Contrast-enhanced Ultrasound

作　　者：张贺彬[1] 高枫[1] 程正才[1] 郑哲岚[2] 黄国庆[1] 余燕成 

机构地区：[1]杭州师范大学附属医院超声科,杭州市310015 [2]浙江大学医学院附属第一医院心血管超声中心

出　　处：《中国超声医学杂志》2017年第4期365-367,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨多房囊性肾瘤(MLCN)和多房囊性肾癌(MCRCC)的超声造影(CEUS)表现,以期提高术前诊断及鉴别诊断的准确度。方法采用回顾性分析经手术病理证实的6例MLCN患者和16例MCRCC患者CEUS表现,对MLCN和MCRCC的部分CEUS表现进行统计学分析。结果6例MLCN和16例MCRCC均表现为肾内单发多房囊性肿块,6例MLCN皮质期均可见增强,囊壁及分隔厚度相对均匀,未见增强实性结节,Bosniak分级主要表现为ⅡF级(2例)和Ⅲ级(4例)。16例MCRCC皮质期亦全部可见增强,囊壁及分隔不均匀增厚伴增强的实性结节8例,Bosniak分级:ⅡF级(2例)、Ⅲ级(6例)、Ⅳ级(8例)。MLCN和MCRCC常规超声表现差异无统计学意义(P>0.05);CEUS表现中,肿瘤囊壁及分隔厚度、有否增强实性结节、增强达峰强度及BosniakⅣ级的差异均有统计学意义(P<0.05)。结论CEUS可对MLCN和MCRCC术前的正确诊断和鉴别诊断提供较多有价值的信息。Objective To study the contrast-enhanced ultrasound（CEUS） findings of multilocular cystic nephroma（MLCN） and multilocular cystic renal cell carcinoma（MCRCC） and to improve the accuracy of preoperative diagnosis and differential diagnosis. Methods The CEUS findings of 6 MLCN cases and 16 MCRCC cases confirmed by pathology were blindly reviewed. Chi-square test and Wilcoxon rank test were applied to statistically analyze some of the CEUS features of the MLCN and MCRCC lesions. Results All tumors in 6 MLCN and 16 MCRCC patients appeared as well-defined multilocular cystic masses complicated fluid. 6 MLCN cases presented relatively thin and even cystic walls and septa,all lesions showed enhancement in the cortical phase without contain soft-tissue enhancing mass inde pendent of the wall and septa, these lesions were categorized by CEUS based on Bosniak classification system mainly for categorylI F（n 2） ,categoryllI （n^4）. 16 MCRCC cases performance were uneven thickening of the wall and sep- ta,all lesions showed enhancement in the cortical phase and 8 cases contain soft-tissue enhancing mass independent of the wall and septa, Bosniak classification system as follows Ⅱ category Ⅱ F（n = 2 ）, category Ⅲ （n = 6 ）, category Ⅳ （n = 8）. MLCN and MCRCC of routine ultrasound showed no significant difference （P〉0.05）. Among the differences of CEUS findings between MLCN and MCRCC, cystic wall and septa thickness, soft-tissue enhancing mass, contrast-enhanced peak intensity, Bosniak category Ⅳ were statistically significantly different（P〈0.05）. Conclusions CEUS can provide some significant evidences for MLCN and MCRCC diagnosis and differential diagnosis.

关 键 词：多房囊性肾瘤 多房囊性肾癌 超声造影 诊断 

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]