超声造影鉴别肾细胞癌亚型及肾血管平滑肌脂肪瘤的临床价值  

Clinical value of contrast-enhanced ultrasound in distinguishing subtypes of renal cell carcinoma and angiomyolipoma

作　　者：樊瑞琪 李廷廷[1] 王婧婕 米娜 王卓然 贾春梅[1] FAN Ruiqi;LI Tingting;WANG Jingjie;MI Na;WANG Zhuoran;JIA Chunmei(Department of Ultrasound,First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院超声科,太原市030001

出　　处：《临床超声医学杂志》2023年第8期621-626,共6页Journal of Clinical Ultrasound in Medicine

摘　　要：目的 探讨超声造影在鉴别肾细胞癌(RCC)亚型及肾血管平滑肌脂肪瘤(AML)中的临床价值。方法 选取我院经病理确诊的肾脏肿瘤患者76例,其中肾透明细胞癌45例(CCRCC组),肾乳头状癌9例(PRCC组),肾嫌色细胞癌8例(CHRCC组),AML 14例(AML组),比较各组常规超声图像特征、超声造影增强模式、超声造影定量参数差值的差异,其中超声造影定量参数差值包括病灶最大增强区域与周围正常肾实质感兴趣区域峰值强度、基础强度、上升斜率、达峰时间、曲线下面积、梯度的差值(ΔPI、ΔBI、ΔSL、ΔTTP、ΔAUC、ΔGrad)。结果 (1)各组常规超声图像特征比较:与AML组比较,CCRCC组以低回声、向外突出生长、内部回声不均匀、有假包膜、富血供表现为主,CHRCC组以低回声、向外突出生长、有假包膜表现为主,PRCC组以低回声、内部回声不均匀表现为主,差异均有统计学意义(均P<0.05);CCRCC组、PRCC组、CHRCC组各常规超声图像特征两两比较差异均无统计学意义。(2)各组超声造影增强模式比较:CCRCC组以“快进”、“慢退”、增强后呈不均匀高增强、环状高增强表现为主,与AML组比较差异均有统计学意义(均P<0.05);AML组以增强均匀为主,与CHRCC组、PRCC组比较差异均有统计学意义(均P<0.05);PRCC组以“慢进”、“快退”、低增强、无环状高增强表现为主,与CCRCC组比较差异均有统计学意义(均P<0.05);CHRCC组以“快退”、等或低增强、无环状高增强表现为主,与CCRCC组比较差异均有统计学意义(均P<0.05);PRCC组与CHRCC组各超声造影增强模式比较差异均无统计学意义;(3)各组超声造影定量参数差值比较:与AML组比较,CCRCC组ΔPI、ΔAUC均增高,ΔBI、ΔTTP均降低,PRCC组ΔBI、ΔTTP均增高,CHRCC组ΔBI降低,差异均有统计学意义(均P<0.05);与CCRCC组比较,PRCC组ΔPI、ΔAUC、ΔGrad均降低,ΔBI、ΔTTP均增高,CHRCC组ΔPI、ΔTTP、ΔAUC均降低,差异均有统�ObjectiveTo explore the clinical value of contrast-enhanced ultrasound in distinguishing subtypes of renal cell carcinoma(RCC) and angiomyolipoma(AML).MethodsSeventy-six patients with renal tumors diagnosed by pathology in our hospital were selected,including 45 cases of clear cell carcinoma(CCRCC group),9 cases of papillary carcinoma(PRCC group),8 cases of chromophobe cell carcinoma(CHRCC group),and 14 cases of AML(AML group).The conventional ultrasound features,contrast-enhanced ultrasound patterns,and the difference of changes of the quantitative parameters of contrast-enhanced ultrasound between the lesion and the surrounding normal renal parenchyma were compared in each group.The changes of quantitative parameters of contrast-enhanced ultrasound including peak intensity,basic intensity,ascending slope,peak time,area under the curve and gradient difference(ΔPI,ΔBI,ΔSL,ΔTTP,ΔAUC,ΔGrad)between the lesion and the surrounding normal renal parenchyma.Results(1)Comparison of conventional ultrasound image features among groups:compared with the AML group,the CCRCC group mainly showed hypoechoic,exophytic growth,heterogeneous internal echo,pseudo capsule,and rich blood supply,the CHRCC group mainly showed hypoechoic,exophytic growth,and pseudo capsule,the PRCC group mainly showed hypoechoic and heterogeneous internal echo,the differences were statistically significant(all P<0.05).There were no significant differences in conventional ultrasound features between CCRCC,PRCC and CHRCC in pairs.(2)Comparison of contrast-enhanced ultrasound patterns among groups:the CCRCC group mainly showed“fast wash-in”and“slow wash-out”,heterogeneous hyperenhancement,and ring-shaped hyperenhancement,which were significantly different from the AML group(all P<0.05).The AML group mainly showed homogeneous enhancement,which was significantly different from the CHRCC and PRCC groups(both P<0.05).The PRCC group mainly showed“slow wash-in”,“fast wash-out”,hypoenhancement,and no ring-shaped hyperenhancement,which were sig

关 键 词：超声检查 造影剂 肾细胞癌 亚型 肾血管平滑肌脂肪瘤 鉴别诊断 

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]