肾透明细胞癌高帧频超声造影时间-强度曲线特征分析  

Characteristics of time-intensity curve of high-frame-rate contrast-enhanced ultrasound in clear cell renal cell carcinoma

作　　者：张卫平[1] 王婧玲 刘志兴[1] 陈莉[1] 谌芳群 Zhang Weiping;Wang Jingling;Liu Zhixing;Chen Li;Chen Fangqun(Department of Ultrasound,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院超声科,南昌330006

出　　处：《中华医学超声杂志（电子版）》2023年第9期916-922,共7页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：江西省科技厅重点研发计划一般项目(20203BBGL73196);江西省卫生健康委员会科技计划项目(202210452);江西省中医药管理局科技计划项目(2021A060)。

摘　　要：目的探讨肾透明细胞癌(CCRCC)高帧频超声造影(H-CEUS)时间-强度曲线(TIC)特征及其临床应用价值。方法选取2022年6月至2023年1月在南昌大学第一附属医院行常规超声造影(C-CEUS)及H-CEUS检查并经手术后病理确诊的CCRCC患者21例。回顾性分析C-CEUS及H-CEUS的TIC曲线特点,获得TIC参数,包括拟合程度(GOF)、基本强度(BI)、始增时间(AT)、达峰时间(TTP)、峰值强度(PI)、上升斜率(AS)、峰值强度减半时间(DT/2)、曲线下降斜率(DS)、曲线下面积(AUC)、平均渡越时间(MTT)。采用配对t检验比较2种超声造影模式下病灶与正常肾皮质的TIC参数差异;并用公式ΔPI=(病灶PI-正常肾皮质PI)/正常肾皮质PI进行校正,以此类推,分别对BI、AT、TTP、AS、DT/2、DS、AUC、MTT进行校正。采用配对Wilcoxon signed-rank检验对H-CEUS及C-CEUS校正后的TIC参数进行比较。结果C-CEUS造影模式中病灶TIC参数PI、DS大于正常肾皮质[(49.93±6.02)dB vs(44.12±7.55)dB;0.24±0.14 vs 0.22±0.12],DT/2、MTT小于正常肾皮质[(140.38±26.51)s vs(150.98±29.27)s;(130.95±26.54)s vs(142.03±29.72)s],差异均具有统计学意义(t=5.300、-3.404、-4.139、-4.095,P<0.001、=0.003、=0.001、=0.001),参数GOF、BI、AT、TTP、AS、AUC差异均无统计学意义(P均>0.05)。H-CEUS造影模式中病灶TIC参数AT、TTP、AS、AUC均小于正常肾皮质[(9.41±2.73)s vs(10.40±3.03)s;(27.17±6.17)s vs(30.13±6.66)s;0.94±0.36 vs 1.07±0.39,3064.47±844.52 vs 3378.62±993.54],PI大于正常肾皮质[(43.34±8.69)dB vs(40.30±7.05)dB],差异均具有统计学意义(t=-3.465、-2.499、-2.688、-2.220、2.211,P=0.002、0.021、0.014、0.038、0.039),参数GOF、BI、DT/2、DS、MTT值差异无统计学意义(P均>0.05)。H-CEUS与C-CEUS校正后的TIC参数比较,H-CEUS的参数ΔAT、ΔAS、ΔAUC均小于C-CEUS[-0.072(-0.180,-0.022)vs-0.025(-0.054,0.053),-0.089(-0.190,0.083)vs 0.034(-0.016,0.074),-0.097(-0.256,-0.004)vs-0.045(-0.079,0.266)],差异具有统计学意义(Z=-2.242Objective To investigate the characteristics and clinical application of the time-intensity curve(TIC)of high-frame-rate contrast-enhanced ultrasound(H-CEUS)in clear cell renal cell carcinoma(CCRCC).Methods A total of 21 patients with CCRCC who underwent conventional contrast-enhanced ultrasound(C-CEUS)and H-CEUS examinations were selected at the First Affiliated Hospital of Nanchang University.TIC parameters of C-CEUS and H-CEUS were acquired and analyzed retrospectively,such as goodness of fit(GOF),base intensity(BI),arrival time(AT),time to peak(TTP),peak intensity(PI),ascending slope(AS),time to half peak intensity(DT/2),descending slope(DS),area under curve(AUC),and mean transit time(MTT).The paired t test was used to compare the TIC parameters of C-CEUS and H-CEUS between the lesions and the normal renal cortex.The equationΔPI=(focal PI-normal renal cortex PI)/normal renal cortex PI was used for correction of BI,AT,TTP,AS,DT/2,DS,AUC,and MTT.Corrected TIC parameters of H-CEUS and C-CEUS were compared by the paired Wilcoxon signed-rank test.Results The C-CEUS TIC parameters PI and DS of the lesions were significantly higher than those of the normal renal cortex[(49.93±6.02)dB vs(44.12±7.55)dB,t=5.300,P<0.001;0.24±0.14 vs 0.22±0.12,t=-3.404,P=0.003],while DT/2 and MTT of the lesions were significantly smaller than those of the normal renal cortex[(140.38±26.51)s vs(150.98±29.27)s,t=-4.139,P=0.001;(130.95±26.54)s vs(142.03±29.72)s,t=-4.095,P=0.001].There were no significant differences in GOF,BI,AT,TTP,AS,or AUC between the lesions and the normal renal cortex(P>0.05 for all).The H-CEUS TIC parameters AT,TTP,AS,and AUC of the lesions were significantly lower than those of the normal renal cortex[(9.41±2.73)s vs(10.40±3.03)s,t=-3.465,P=0.002;(27.17±6.17)s vs(30.13±6.66)s,t=-2.499,P=0.021;0.94±0.36 vs 1.07±0.39,t=-2.688,P=0.014;3064.47±844.52 vs 3378.62±993.54,t=-2.220,P=0.038],PI of the lesions was significantly greater than that of the normal renal cortex[(43.34±8.69)dB vs(40.30±7.05)dB,t=2.2

关 键 词：肾透明细胞癌 高帧频 超声造影 时间-强度曲线 特征 

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]