超声造影对不同病理类型肾脏实性肿瘤的定性诊断价值  

Qualitative Diagnostic Value of Contrast-enhanced Ultrasound in Different Pathological Types of Renal Solid Tumors

作　　者：王颖鑫[1] 杨凌菲 朱晨晨 WANG Ying-xin;YANG Ling-fei;ZHU Chen-chen(Department of Ultrasound Medicine,The First Affiliated Hospital of Xinjiang Medical University,Wulumuqi 830054,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆医科大学第一附属医院超声科,新疆乌鲁木齐830054

出　　处：《中国CT和MRI杂志》2024年第2期121-124,共4页Chinese Journal of CT and MRI

基　　金：新疆维吾尔自治区自然科学基金(2020D01C229)。

摘　　要：目的应用超声造影观察不同病理类型肾脏实性肿瘤灌注特征,探究其定性诊断价值。方法回顾性分析415例肾脏实性肿瘤超声造影(contrast-enhanced ultrasonography,CEUS)图像特征,以病理结果为“金标准”,分为良恶性组,良性组分为肾血管平滑肌脂肪瘤(RAML)、肾嗜酸细胞瘤(RO),恶性组包括肾透明细胞癌(CCRCC)和肾乳头状细胞癌(PRCC)及肾嫌色细胞癌(ChRCC)亚组,采用单因素分析法比较良、恶性组间及恶性组内病灶CEUS特征差异有无统计学意义,对差异有统计学意义的变量行多因素Logistic回归分析,比较其诊断价值。结果良恶性组间病灶增强方式、增强程度、环状高增强或未增强区是否存在差异均有统计学意义(P<0.05);恶性组主要表现为快进(196/333,58.86%)、高增强(174/333,52.25%),环状高增强(225/333,67.57%)及未增强区(236/333,70.87%),良性组主要表现为等进(52/82,64.41%)、等增强(57/82,69.51%)。恶性组内病灶增强方式、程度差异具有统计学意义(P<0.05);CCRCC主要表现为快进(166/284,58.45%)、高增强(171/284,60.21%),PRCC及ChRCC主要表现为慢进(30/49,61.38%)、低增强(32/49,65.31%)。结论超声造影能够显示肿瘤的血流灌注特征,可为不同病理类型肾脏肿瘤的诊断提供重要的参考价值。Objective To observe the perfusion characteristics of renal solid tumors of different pathological types by contrast-enhanced ultrasound and explore its qualitative diagnostic value.Methods The ultrasonographic features of 415 cases of renal solid tumors(CEUS)were analyzed retrospectively.According to the pathological results,they were divided into benign and malignant groups.The benign group included renal angiomyolipoma(RAML)and renal eosinophilia(RO).Malignant group includes renal clear cell carcinoma(CCRCC),renal papillary cell carcinoma(PRCC)and renal chromophobe cell carcinoma(ChRCC)subgroups.Single factor analysis is better.Whether there is statistical difference in CEUS characteristics between malignant groups and within malignant groups,multivariate Logistic regression analysis is performed on the variables with statistical significance to compare their diagnostic values.Results There were significant differences between benign and malignant groups in the enhancement mode,enhancement degree,annular high enhancement and unenhanced area(P<0.05).The malignant group showed fast-forward(196/333,58.86%),high enhancement(174/333,52.25%),annular high enhancement(225/333,67.57%)and non-enhanced area(236/333,70.87%),while the benign group showed equal progress.There were significant differences in the enhancement mode and degree of lesions in malignant groups(P<0.05).CCRCC showed fast forward(166/284,58.45%)and high enhancement(171/284,60.21%),while PRCC and ChRCC showed slow forward(30/49,61.38%)and low enhancement(32/49,65.31%).Conclusion Contrast-enhanced ultrasound can show the blood perfusion characteristics of tumors,which can provide important reference value for the diagnosis of different pathological types of renal tumors.

关 键 词：超声造影 肾细胞癌 诊断 鉴别 

分 类 号：R692[医药卫生—泌尿科学]