螺旋CT与超声血管造影在肾癌诊断中的临床价值对比  

A comparative study of spiral CT and ultrasonic angiography in the diagnosis of renal carcinoma

作　　者：王月 WANG Yue(Liaoyang Central Hospital Xincheng Hospital,Liaoyang 111000,China)

机构地区：[1]辽阳市中心医院新城医院,111000

出　　处：《中国现代药物应用》2022年第16期101-103,共3页Chinese Journal of Modern Drug Application

摘　　要：目的对比螺旋CT与超声血管造影在肾癌诊断中的临床价值。方法50例存在肾脏小肿物的患者,均开展螺旋CT与超声血管造影检查,符合条件者开展药物血管造影检查。以病理诊断结果作为金标准,比较螺旋CT与超声血管造影的诊断准确率;观察超声血管造影的影像学表现。结果50例患者中,经手术治疗32例、活检18例。病理诊断结果:小肾癌28例,其中混合细胞癌4例,肾透明细胞癌24例;良性肿物22例,其中炎性包块6例,肾囊肿6例,血管平滑肌脂肪瘤4例,正常肾结构6例。50例患者肾脏肿物直径1.1~3.2 mm,平均直径(2.6±0.3)mm。超声血管造影的诊断准确率为96.0%,高于螺旋CT的84.0%,差异具有统计学意义(P<0.05)。34例接受药物血管造影患者中,包括16例良性肿物、18例小肾癌,患者均取得正确诊断。小肾癌的药物血管造影影像学表现:正常肾小叶间动脉和与之相关的下分支显著收缩,并未显影;癌灶的瘤血管以及相关供养动脉未发现收缩现象,清晰度更高。良性肿物的药物血管造影影像学表现:叶间动脉受到压迫,发生推移,不存在显著的肿瘤血管;血管平滑肌脂肪瘤中显示很多新生肿瘤血管、动脉瘤样表现以及肿瘤染色,药物注射后,血管的造影供氧动脉以及肿瘤血管表现出收缩样,肿瘤的染色消失情况和恶性癌灶存在较大不同。结论相较于螺旋CT检查,对肾癌患者开展超声血管造影有着更好的诊断价值,值得进一步在临床内推广以及应用。Objective To compare the clinical value of spiral CT and ultrasonic angiography in the diagnosis of renal carcinoma.Methods 50 patients with renal small masses were selected,and spiral CT and ultrasonic angiography were performed on all the subjects,and drug angiography was performed for those meeting the criteria.Using pathological diagnosis results as the gold standard,the diagnostic accuracy of spiral CT and ultrasonic angiography were compared;the imaging manifestations of ultrasonic angiography were observed.Results Of the 50 patients,32 underwent surgery and 18 underwent biopsy.Pathological diagnosis results:28 cases of small renal cell carcinoma,including 4 cases of mixed cell carcinoma,24 cases of renal clear cell carcinoma;22 cases of benign tumor,including 6 cases of inflammatory mass,6 cases of renal cyst,4 cases of angiomyolipoma,6 cases of normal renal structure.The diameter of renal tumors in 50 patients was 1.1-3.2 mm,with an average diameter of(2.6±0.3)mm.The diagnostic accuracy of ultrasonic angiography was 96.0%,which was higher than 84.0%of spiral CT,and the difference was statistically significant(P<0.05).Among the 34 patients who received drug angiography,16 cases of benign tumor and 18 cases of small renal carcinoma were correctly diagnosed.Drug angiography imaging of small renal carcinoma showed:there were significant constriction of the normal interlobular arteries and associated inferior branches,which were not visualized;no constriction was found in the tumor vessels of the carcinoma and associated feeding arteries,which were more clearly defined.Drug angiographic imaging of benign masses showed:interlobular arteries were compressed,nudging occurred,and no significant tumor vessels were present;vascular smooth muscle lipomas showed many neoplastic vessels,aneurysmal-like manifestations,and tumor staining,and after drug injection,the angiographic oxygen supply arteries as well as tumor vessels showed constriction-like,and the disappearance of tumor staining differed greatly from that of

关 键 词：螺旋CT 超声血管造影 肾癌 价值 

分 类 号：R737.11[医药卫生—肿瘤] R445.1[医药卫生—临床医学] R730.44