超声造影在肾透明细胞癌与尿路上皮癌鉴别诊断中的价值  

Value of contrasten hanced ultrasound in the differential diagnosis of renal clear cell carcinoma and urothelial carcinoma

作　　者：冯连云 田晶[1] 王光霞[3] 刘甚佳 王红 庞丽娜 FENG Lianyun;TIAN Jing;WANG Guangxia;LIU Shenjia;WANG Hong;PANG Lina(The Second Hospital of Tianjin Medical University,Tianjin 300211,China;Zhongshanmenjie Community Health Service Center,Hedong Districct of Tianjin;Tianjin Nankai Hospital)

机构地区：[1]天津医科大学第二医院,300211 [2]天津市河东区中山门街社区卫生服务中心 [3]天津市南开医院

出　　处：《天津医药》2023年第5期540-543,共4页Tianjin Medical Journal

摘　　要：目的应用超声造影观察肾内型肾透明细胞癌与尿路上皮癌的血流灌注特点,探讨其鉴别诊断价值。方法收集经病理证实的肾内恶性肿瘤患者105例,其中肾透明细胞癌57例,尿路上皮癌48例。对患者进行常规超声及超声造影检查,比较2组间常规超声下的长径和回声特点;超声造影的增强时间差、增强达峰时间差、增强模式及增强强度;采用受试者工作特征(ROC)曲线分析增强时间差、增强达峰时间差对肾内肿瘤的诊断价值。结果肾透明细胞癌组最大长径长于尿路上皮癌组(P<0.01),常规超声均以低回声为主;肾透明细胞癌组增强时间差和增强达峰时间差短于尿路上皮癌组(P<0.05)。2组造影后肿物增强模式均以快进快退为主,2组增强强度差异有统计学意义(P<0.01)。ROC曲线提示增强时间差鉴别诊断肾透明细胞癌与尿路上皮癌的效能优于增强达峰时间差(Z=3.600,P<0.01)。结论超声造影可以作为常规超声在鉴别肾透明细胞癌和尿路上皮癌的重要补充。Objective To observe blood perfusion characteristics of renal clear cell carcinoma and urothelial carcinoma by contrasten hanced ultrasound,and to explore their differential diagnostic value.Methods A total of 105 patients with renal malignant tumor confirmed by pathology were collected,including 57 cases of renal clear cell carcinoma and 48 cases of urothelial carcinoma.Conventional ultrasound and contrast-enhanced ultrasound were performed to compare the length diameter and echo characteristics of conventional ultrasound between the two groups.Enhancement time difference,enhancement peak time difference,enhancement mode and enhancement intensity of contrast-enhanced ultrasound were also compared between the two groups.Receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of enhanced time difference and enhanced peak time difference for intrarenal tumors.Results The mean length diameter of the renal clear cell carcinoma group was longer than that of the urothelial carcinoma group(P<0.01).The enhancement time difference was shorter in the renal clear cell carcinoma group than that in the urothelial carcinoma group,and the enhancement peak time difference was shorter than that in the urothelial carcinoma group(P<0.05).There was no significant difference in the enhancement pattern between the two groups after angiography.The enhancement pattern of the tumor after angiography was mainly rapid advance and rapid retreat in the two groups.There was significant difference in enhancement intensity between the two groups(P<0.01).The ROC curve suggested that enhanced time difference was more effective than enhanced time difference in the differential diagnosis of renal clear cell carcinoma and uroepithelial carcinoma(Z=3.600,P<0.01).Conclusion Contrast enhanced ultrasound can be used as an important supplement to conventional ultrasound in differentiating renal clear cell carcinoma from urothelial carcinoma.

关 键 词：癌 肾细胞 尿道肿瘤 超声造影 鉴别诊断 

分 类 号：R692.9[医药卫生—泌尿科学] R445.1[医药卫生—外科学]