双重超声造影在肾囊性病变鉴别诊断中的价值:与增强磁共振和静脉肾盂造影的对比研究  

Diagnostic value of double contrast-enhanced ultrasound in renal cystic lesions:a comparative study with enhanced magnetic resonance and intravenous pyelogram

作　　者：汪丽菁 欧笛 李明奎[2] 张亦青 徐栋 Wang Lijing;Ou Di;Li Mingkui;Zhang Yiqing;Xu Dong(Department of Ultrasound,Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences,Cancer Hospital of University of Chinese Academy of Sciences,Zhejiang Cancer Hospital,Hangzhou 310000,China;Department of Interventional Ultrasound,Zhejiang Xiaoshan Hospital,Hangzhou 310000,China)

机构地区：[1]中国科学院大学附属肿瘤医院(浙江省肿瘤医院)超声医学科,中国科学院基础医学与肿瘤研究所,杭州310000 [2]浙江萧山医院超声介入科,杭州310000

出　　处：《中华超声影像学杂志》2022年第7期620-625,共6页Chinese Journal of Ultrasonography

基　　金：浙江省自然科学基金重大项目(LSD19H180001)。

摘　　要：目的探讨双重超声造影在肾囊性病变鉴别诊断中的应用价值。方法选择2019年1月至2020年10月浙江省肿瘤医院和浙江萧山医院常规超声诊断为肾囊肿,预行硬化治疗的84例患者为研究对象,分别行静脉超声造影及增强MRI检查进行良恶性判断,对预行肾囊肿硬化治疗的良性患者行静脉肾盂造影及囊内超声造影检查排除肾盂源性囊肿,比较双重超声造影结果与MRI及静脉肾盂造影的诊断差异。结果84例疑诊肾囊肿患者中,对于诊断囊性肾癌,增强MRI诊断准确性为97.62%、敏感性为100%、特异性为97.46%,静脉超声造影诊断准确性为98.81%、敏感性为100%、特异性为98.73%,两组间比较差异无统计学意义(均P>0.05)。诊断为良性肾囊肿者77例,静脉肾盂造影的肾盂源性囊肿检出率为9.1%(7/77),囊内超声造影的肾盂源性囊肿检出率为6.5%(5/77)。以静脉肾盂造影为金标准,囊内超声造影诊断准确性为97.4%(75/77)、敏感性为71.4%(5/7)、特异性为100%(70/70)。结论肾囊肿硬化治疗中双重超声造影与增强MRI和静脉肾盂造影相比,良恶性诊断效能无差异,对肾盂源性囊肿诊断效能高且操作方便,可一次性排除囊性肾癌及肾盂来源囊肿,提高硬化治疗安全性。Objective To explore the application value of dual contrast-enhanced ultrasound in the differential diagnosis of renal cystic lesions.Methods Eighty-four cases with renal cysts who were diagnosed by routine ultrasound in Zhejiang Cancer Hospital and Zhejiang Xiaoshan Hospital from January 2019 to October 2020 were included in the study.Intravenous contrast-enhanced ultrasound and enhanced MRI were performed to differentiate benign and malignant cysts.Patients with benign cysts underuent intravenous pyelography and intracapsular contrast-enhanced ultrasound.Before sclerotheraphy to exclude renal pelvic cysts.The diagnostic results of dual radiography were compared with MRI and intravenous pyelography.Results Among 84 patients with suspected renal cysts,the diagnostic accuracy of enhanced MRI for cystic renal cancer was 97.62%,and the sensitivity was 97.62%.The diagnostic accuracy of intravenous contrast-enhanced ultrasound was 98.81,the sensitivity was 100%,and the specificity was 98.73%.There was no statistically significant difference between the two groups(all P>0.05).77 cases were diagnosed as benign renal cysts,the detection rate of intravenous pyelography was 9.1%(7/77),the detection rate of renal pelvic cysts by intracystic ultrasonography was 6.5%(5/77).With intravenous pyelography as the gold standard,the diagnostic accuracy of intracapsular contrast-enhanced ultrasound was 97.4%(75/77),the sensitivity was 71.4%(5/7),and the specificity was 100%(70/70).Conclusions Compared with enhanced magnetic resonance and intravenous pyelography before renal cyst sclerosing therapy,there is no difference in diagnostic efficiency of double contrast ultrasound for benign and malignant cysts.The diagnostic efficiency of renal pelvic cysts is high,and the operation is convenient.It can identify cystic renal cancer and cysts from the renal pelvis and improve the safety of sclerotherapy.

关 键 词：超声造影 肾囊肿 硬化治疗 造影剂 

分 类 号：R692[医药卫生—泌尿科学]