高帧频超声造影对小肾透明细胞癌假包膜的评价价值  

Value of high-frame-rate contrast-enhanced ultrasound in evaluation of pseudocapsule sign in small clear cell renal carcinoma

作　　者：李秋洋[1] 赵萍 李静波 宋禄达 朱嘉宁 姜波[1] 罗渝昆[1] Qiuyang Li;Ping Zhao;Jingbo Li;Luda Song;Jianing Zhu;Bo Jiang;Yukun Luo(Department of Ultrasonography,the First Medical Centre of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心超声科,北京100853

出　　处：《中华医学超声杂志（电子版）》2023年第11期1114-1118,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨高帧频超声造影(H-CEUS)评价小肾透明细胞癌(S-CCRCC)假包膜的价值。方法回顾性分析2022年9月至2023年4月在解放军总医院第一医学中心经手术病理证实为S-CCRCC的患者80例,按照肿瘤大小分为2组:最大径≤2.0 cm组(30例)和最大径2.1~4.0 cm组(50例)。对研究对象分别行常规超声造影及H-CEUS检查并留存图像资料,再由2名观察者分别对超声造影和H-CEUS图像进行分析,按造影过程中假包膜的显示程度给出评价结果:完全可见、部分可见、完全不可见。对超声造影和H-CEUS图像特征和结果进行统计分析,采用Kappa检验进行2名观察者间的一致性检验。结果2名观察者对2组S-CCRCC假包膜的评价结果:H-CEUS的显示均优于常规超声造影,应用H-CEUS评价S-CCRCC周边假包膜完全可见的比例较常规超声造影有所提高;常规超声造影模式下,2名观察者对S-CCRCC周边假包膜的评价一致性一般:在≤2.0 cm组,Kappa系数为0.605[95%可信区间(CI)为0.396~0.814];在2.1~4.0 cm组,Kappa系数为0.745(95%CI为0.568~0.922);H-CEUS模式下,2名观察者对S-CCRCC周边假包膜的评价一致性较好:在≤2.0 cm组,Kappa系数为0.813(95%CI为0.646~0.980);在2.1~4.0 cm组,Kappa系数为0.862(95%CI为0.709~1.000)。结论H-CEUS可以使S-CCRCC的假包膜显示得更加清楚,而且不同观察者间评价结果的一致性上有明显提高。Objective To evaluate the value of high-frame-rate contrast-enhanced ultrasound(H-CEUS)in evaluating the pseudocapsule sign in small clear cell renal carcinoma(S-CCRCC).Methods A retrospective analysis was performed on 80 cases of S-CCRCC confirmed by surgery and pathology at the First Medical Center of PLA General Hospital from September 2022 to April 2023,and they were divided into two groups according to tumor size:maximum diameter≤2.0 cm group(n=30)and maximum diameter 2.1-4.0 cm group(n=50).Conventional CEUS and H-CEUS examinations were performed on the study subjects and the image data were recorded.Then,the conventional CEUS and H-CEUS images were analyzed by two observers respectively,and the evaluation results were given according to the display degree of the pseudocapsule sign during conventional CEUS and H-CEUS:completely visible,partially visible,and completely invisible.The features and results of CEUS and H-CEUS images were statistically analyzed,and Kappa test was used to assess the consistency in the evaluation results of the two observers.Results In the evaluation results of the two groups of S-CCRCC,the display of the pseudocapsule sign by H-CEUS was better than that by CEUS,and the proportion of cases with completely visible pseudocapsule sign of S-CCRCC was improved.In the CEUS mode,the Kappa coefficient for the pairwise comparison between the two observers was 0.605 in the≤2.0 cm group[95%confidence interval(CI):0.396-0.814],and it was 0.745(95%CI:0.568-0.922)in the 2.1-4.0 cm group.In the H-CEUS model,the Kappa coefficient in the≤2.0 cm group was 0.813(95%CI:0.646-0.980),and it was 0.862(95%CI:0.709-1.000)in the 2.1-4.0 cm group.Conclusion H-CEUS can make the pseudocapsule sign of S-CCRCC more clearly displayed,and the consistency of evaluation results between different observers is significantly improved.

关 键 词：超声造影 高帧频 小肾癌 假包膜 

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