高回声小肾癌的常规超声诊断特点及策略探讨:一项单中心研究  

The diagnostic characteristics and strategies of conventional ultrasonography in hyperechoic small renal cell carcinoma:a single-center study

作　　者：蔡石龙 钟志方[1] Cai Shilong;Zhong Zhifang(Departments of Ultrasound,Xuzhou Central Hospital,Xuzhou 221009,China)

机构地区：[1]徐州市中心医院超声医学科,徐州221009

出　　处：《国际泌尿系统杂志》2024年第3期470-473,共4页International Journal of Urology and Nephrology

摘　　要：目的:探讨高回声小肾癌的常规超声诊断特点及策略,以期提高小肾癌的临床诊断准确率。方法:回顾性分析2016年8月至2022年6月在本院经外科手术证实的52例高回声小肾癌患者的超声特点及诊疗经历,附CT检查。瘤体长径为8~25 mm。肿瘤回声根据与肾实质相对比分为稍高回声和高回声。结果:52例小肾癌中,透明细胞癌49例,乳头状细胞癌2例,多房囊性肾细胞癌1例。稍高回声45例、高回声7例。12例超声首诊为错构瘤,后续超声召回9例采取随访处理者,3例于召回前已经手术确诊;8例超声首诊未发现肿瘤,而CT提示有占位,经临床反馈后再行超声复核确诊;10例CT提示未见肿瘤,后行超声召回6例采取临床随访处理者,4例于召回前已手术确诊;另1例超声及CT均未发现肿瘤,后行增强检查提示占位,超声复核确诊。超声联合CT的检出率高于超声首诊检出率,差异有统计学意义[98.08%(51/52)vs.82.69%(43/52),χ^(2)=7.081,P=0.008]。结论:高回声小肾癌超声易误诊为错构瘤。超声召回行为改变了部分小肾癌患者的病程,超声联合CT有利于降低小肾癌的漏诊率。Objective To explore the characteristics and strategies of conventional ultrasonography in the diagnosis of hyperechoic small renal cell carcinoma,and improve the clinical diagnosis accuracy of small renal cell carcinoma.Methods A total of 52 cases of hyperechoic small renal cell carcinoma confirmed by surgery in our hospital between August 2016 and June 2022 were retrospectively analyzed for the ultrasound characteristics and diagnosis and treatment experience,with CT examinations attached.Tumor length and diameter of 8-25 mm.Tumor echoes were classified as slightly hyperechoic or hyperechoic according to the relative ratio of the tumor to the renal parenchyma.Results Among the 52 cases of small renal cell carcinoma,49 cases were clear cell carcinoma,2 cases were papillary cell carcinoma,and 1 case was multilocular cystic renal cell carcinoma.Forty-five cases were slightly hyperechoic,7 cases were hyperechoic.Twelve cases were first diagnosed as renal angiomyolipoma by ultrasound,9 cases were recalled by ultrasound for follow-up,and 3 cases had been diagnosed by surgery before the recall.No tumor was found in the first ultrasound diagnosis of 8 cases,while CT suggested space-occupying,which was confirmed by clinical feedback and subsequent ultrasound review.Ten cases of CT scan showed no tumor,6 cases were recalled by ultrasound,and 4 cases had been diagnosed by surgery before the recall.In the other case,no tumor was found on ultrasound or CT,and subsequent enhancement suggested space-occupying,which was confirmed by ultrasound review.The detection rate of ultrasound combined with CT was higher than that of first ultrasound diagnosis,and the difference was statistically significant[98.08%(51/52)vs.82.69%(43/52),χ^(2)=7.081,P=0.008].ConclusionssHyperechoic small renal cell carcinoma is easily misdiagnosed as renal angiomyolipoma by ultrasonography.Ultrasound recall changed the course of disease in some patients with small renal tumors.Ultrasound combined with CT helps to reduce the missed diagnosis rate of smal

关 键 词：肾肿瘤 超声检查 错构瘤 

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