超微血管显像联合增强CT诊断直径<3cm肾脏肿瘤的价值  

Value of super microvascular imaging combined with enhanced CT in the diagnosis of kidney tumor with diameter<3cm

作　　者：许莹[1] 周瑜[2] 李丽娜[2] 樊星 XU Ying;ZHOU Yu;LI Li’na;FAN Xing(Department of Ultrasound,the Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University,Jiangsu 215000,China)

机构地区：[1]南京医科大学附属苏州科技城医院超声科,江苏省苏州市215000 [2]大连市中心医院超声科

出　　处：《临床超声医学杂志》2021年第12期951-954,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超微血管显像(SMI)联合增强CT诊断直径<3 cm肾脏肿瘤(以下简称小肾肿瘤)的临床应用价值。方法选取我院收治的经病理证实的小肾肿瘤患者118例(良性72例,恶性46例),分析良恶性病变SMI和增强CT表现的差异。应用相关性分析法分析SMI特征与良恶性病变的关系;绘制受试者工作特征(ROC)曲线分析SMI、增强CT单独及联合应用对小肾肿瘤的诊断效能。结果 SMI检查显示良恶性病变血流分级、血流形态、血流分布模式、周边环形血流情况比较差异均有统计学意义(均P<0.05)。增强CT检查显示,良性病变中65例表现为"慢退慢进",7例表现为"慢退快进";恶性病变中35例表现为"快进快退",11例表现为"快进慢退";良恶性病变增强CT表现比较差异均有统计学意义(均P<0.05)。相关性分析显示,SMI血流分级、分布模式与良恶性病变均呈正相关,血流形态、周边环形血流与良恶性病变均呈负相关(均P=0.000)。ROC曲线分析显示,SMI诊断小肾肿瘤的曲线下面积为0.746,敏感性80.51%,特异性68.75%;增强CT诊断小肾肿瘤的曲线下面积为0.677,敏感性72.88%,特异性62.50%;两者联合诊断小肾肿瘤的曲线下面积为0.956,敏感性97.46%,特异性93.75%,均高于单独应用,差异均有统计学意义(均P<0.05)。结论 SMI联合增强CT对小肾肿瘤有较高诊断价值。Objective with enhanced CT in the diagnosis of kidney tumor with diameter<3 cm(hereinafter referred to as small kidney tumor).MethodsTotally 118 patients with small kidney tumors were selected,all comfired by pathology,including 72 cases of benign and 46 cases of malignant.The difference of the SMI and enhanced CT manifestations between benign and malignant lesions were analyzed.The correlation between SMI characteristics and benign and malignant lesions were analyzed.Receiver operating characteristic(ROC) curve was drawn to analyze the diagnostic efficacy of SMI,enhanced CT and their combination for small kidney tumors.Results morphology,blood flow distribution pattern,and peripheral circular blood flow of benign and malignant lesions(all P<0.05).Enhanced CT showed that there were 65 benign cases with the characteristics of“slow retreat and slow forward”,and 7 benign cases with the characteristics of“slow retreat and fast forward”.There were 35 malignant cases with the characteristics of“fast forward and fast retreat”,and 11 malignant cases with the characteristics of“fast forward and slow retreat”.There were statistical differences between the benign and malignant lesions(all P<0.05).Correlation analysis showed that SMI blood flow classification and distribution pattern were positively correlated with benign and malignant lesions,and blood flow morphology and peripheral circular blood flow were negatively correlated with benign and malignant lesions(all P=0.000).ROC curve analysis showed that the area under the curve of SMI in the diagnosis of small kidney tumors was 0.746,the sensitivity was 80.51%,and the specificity was 68.75%.The area under the curve of enhanced CT in the diagnosis of small kidney tumors was 0.677,the sensitivity was 72.88%,and the specificity was 62.50%.The area under the curve of the combined diagnosis of small kidney tumors was 0.956,the sensitivity was 97.46%,and the specificity was 93.75%,which were higher than those of the application alone,and the differences were sta

关 键 词：超微血管显像 增强CT 肾肿瘤 良恶性 

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]