多层螺旋CT增强扫描与超声造影对小于3 cm的肾肿瘤的诊断价值的对照研究  

Comparative Study of Multi-slice Spiral CT Enhanced Contrast and Contrast-enhanced Ultrasonography in the Diagnosis of Renal Tumors Less than 3 cm

作　　者：王江玥[1] WANG Jiangyue.(Beibei District Chinese Medicine Hospital, Chongqing,40070)

机构地区：[1]重庆市北碚区中医院,400700

出　　处：《实用癌症杂志》2018年第4期675-678,682,共5页The Practical Journal of Cancer

摘　　要：目的比较多层螺旋CT增强扫描(CECT)与超声造影(CEUS)对直径小于3 cm的肾肿瘤的诊断价值。方法以直径小于3 cm的肾肿瘤患者93例为研究对象,分别采用CECT及CEUS诊断,以CEUS观察病灶的血流信号,比较2种方法的增强均匀度、增强强度、增强消退时间、假包膜征。以术后病理结果为金标准,评价其诊断符合率、灵敏度、特异度、预测值。结果术后病理诊断肾恶性肿瘤71例,肾良性肿瘤22例。良恶性肿瘤的血流信号等级的差异有统计学意义(χ~2=51.962,P<0.01)。CECT与CEUS在增强强度、增强消退时间及假包膜症等影像学表现的差异均有统计学意义(P<0.05)。CEUS诊断准确率为92.47%,诊断的一致性优(Mc Nemarχ~2=0.029,P>0.05),诊断灵敏度、特异度、阳性预测值与阴性预测值分别为94.37%、86.36%、95.71%、82.61%;CECT诊断准确率为90.32%,诊断的一致性优(McNemarχ~2=0.024,P>0.05),诊断灵敏度、特异度、阳性预测值与阴性预测值分别为92.96%、81.82%、94.29%、78.26%。结论 CECT与CEUS对小于3 cm的肾肿瘤均有较优的诊断能力,都能较准确地判断肿瘤的良恶性,CEUS诊断准确性相对更高。Objective To compare the diagnostic value of multi-slice spiral CT enhanced contrast （CECT） and contrast- enhanced ultrasonography （CEUS） in renal tumors with diameter less than 3 cm. Methods 35 patients with renal tumors with diameter less than 3 cm were enrolled in this study. CECT and CEUS were used to observe the blood flow signal of CEUS, the en- hancement uniformity, enhancement intensity, enhancement regression time, pseudo-capsule Levy. The diagnostic accuracy, sensi- tivity, specificity and predictive value were evaluated by postoperative pathological results. Results There were 71 cases of renal malignant tumors and 22 cases of benign renal tumors. The difference of blood flow signal grade between benign and malignant tumors was statistically significant （χ2 = 51. 962, P 〈 0. 01 ）. There were significant differences in the imaging findings between CECT and CEUS in enhancement of intensity, enhanced regression time and pseudo-capsat （P 〈 0.05）. The diagnostic accuracy, specificity, positive predictive value and negative predictive value are 94.37%, 86.36%, 95.71% and 82.61% respectively, and the diagnostic accuracy is 92.47% and the diagnostic consistency is excellent （ McNemarχ2 = 0. 029, P 〉 0.05 ）. The diagnostic accuracy, specificity, positive predictive value and negative predictive value are 92.96%, 81.82%, 94.29 % and 78.26% respec- tively. The diagnostic accuracy is 90.32% and the diagnostic consistency is excellent （ McNemarχ2 = 0. 024 ,P 〉 0.05 ）. Conclu- sion CECT and CEUS have better diagnostic ability for renal tumors less than 3 cm, and can judge the benign and malignant tumor. CEUS diagnosis is relatively accurate.

关 键 词：肾肿瘤 超声造影 体层摄像术 X线计算机 

分 类 号：R737.11[医药卫生—肿瘤]