超声造影联合增强CT在肾占位性病变中的应用价值  

Value of Contrast-Enhanced Ultrasound Combined with Enhanced CT in Renal Space-Occupying Lesions

作　　者：柴学云 霍学军 李娟 CHAI Xue-yun;HUO Xue-jun;LI Juan(Department of Ultrasound,Dezhou Traditional Chinese Medicine Hospital,Dezhou 253000,Shandong Province,China;Department of Imaging,Dezhou Traditional Chinese Medicine Hospital,Dezhou 253000,Shandong Province,China)

机构地区：[1]德州市中医院超声科,山东德州253000 [2]德州市中医院影像科,山东德州253000

出　　处：《中国CT和MRI杂志》2022年第4期118-120,129,共4页Chinese Journal of CT and MRI

摘　　要：目的分析超声造影(CEUS)联合增强CT在肾占位性病变中的应用价值。方法回顾性分析2018年5月至2019年11月我院经手术及病理证实的75例78个肾脏占位患者,其中良性、恶性占位分别17个、61个,术前均接受CEUS、增强CT检查,观察其影像学特点,分析不同病理类型肾占位性病变的相对CEUS参数,比较CEUS、增强CT两者单独及联合的诊断价值。结果肾脏恶性肿瘤的CEUS模式多样化,呈快进快出、不均匀高增强或慢进快出、不均匀低增强,“假包膜”征,良性占位多表现为同进同出、不均匀等增强;增强CT显示肾恶性肿瘤呈类圆形低密度团块,注射造影剂后肿块典型表现为快进快出、不均匀高增强或低增强,良性肿块呈等密度或稍高密度肿块,边缘清晰,各期均匀强化。CEUS下,恶性占位的△IMAX高于良性占位,而△RT、△TTP、△m TT短于良性占位(P<0.01);CEUS联合增强CT诊断恶性占位的特异度、准确度高于CEUS、增强CT(P<0.05),CEUS、增强CT诊断恶性占位的灵敏度、特异度、准确度比较差异无统计学意义(P>0.05)。结论CEUS联合增强CT对肾恶性占位性病变的特异度、准确度较高,不同病理类型的肾占位性病变CEUS参数有一定差异,两者联合检查提供了更丰富的诊断信息。Objective To analyze the value of contrast-enhanced ultrasound(CEUS)combined with enhanced CT in renal space-occupying lesions.Methods A retrospective analysis was conducted among 75 patients with 78 renal space-occupying lesions confirmed by surgery and pathology in the hospital between May 2018 and November 2019,including 17 benign lesions and 61 malignant ones.All patients completed CEUS and enhanced CT examinations,and the imaging characteristics were observed.The relative CEUS parameters of different pathological types of renal space-occupying lesions were analyzed,and the value of CEUS and enhanced CT combined and alone diagnosis was compared.Results The CEUS patterns of malignant renal tumors were diversified,showing fast-in,fast-out,inhomogeneous high enhancement or slow-in,fast-out,inhomogeneous low enhancement and false envelope sign,while benign space-occupying lesions manifested as the same time in and out,inhomogeneous equal enhancement.Enhanced CT showed that malignant renal tumors were round low-density masses.After injecting contrast agent,the masses typically showed fast-in,fastout,inhomogeneous high enhancement or low enhancement.Benign masses were equal density or slightly high density masses,with clear margins and homogeneous enhancement in all stages.Under CEUS,the△IMAX of malignant space-occupying lesions was higher than benign ones,but△RT,△TTP and△m TT were shorter than benign space-occupying lesions(P<0.01).The specificity and accuracy of CEUS combined with enhanced CT in the diagnosis of malignant space-occupying lesions were higher than those of CEUS or enhanced CT(P<0.05),but there was no significant difference in the sensitivity,specificity or accuracy between CEUS and enhanced CT in the diagnosis of malignant space-occupying lesions(P>0.05).Conclusion The specificity and accuracy of CEUS combined with enhanced CT are relatively higher in the diagnosis of malignant renal space-occupying lesions.The CEUS parameters of different pathological types of renal space-occupying lesions

关 键 词：超声造影 增强CT 肾占位性病变 

分 类 号：R445.1[医药卫生—影像医学与核医学] R445.3[医药卫生—诊断学]