多模态超声鉴别诊断肾实性肿块良恶性的临床价值  

Clinical value of multimodal ultrasound in the differential diagnosis of benign and malignant renal solid masses

作　　者：陈成生 黄友锋 左晓林 CHEN Chengsheng;HUANG Youfeng;ZUO Xiaolin(Department of Ultrasound,Mindong Hospital Affiliated to Fujian Medical University,Fujian 355000,China)

机构地区：[1]福建医科大学附属闽东医院超声科,福建省福安市355000

出　　处：《临床超声医学杂志》2024年第6期505-509,共5页Journal of Clinical Ultrasound in Medicine

摘　　要：目的应用CDFI、超微血管成像(SMI)、超声造影(CEUS)鉴别诊断肾实性肿块良恶性,探讨多模态超声的临床应用价值。方法选取我院病理证实的肾实性肿块患者59例,均为单发病灶,其中良性13例,恶性46例,均行CDFI、SMI及CEUS检查,比较各方法及多模态超声鉴别诊断肾实性肿块良恶性的灵敏度、特异度、准确率。绘制受试者工作特征(ROC)曲线分析各方法及多模态超声对肾实性肿块良恶性的鉴别诊断效能。结果59例患者中,CDFI诊断良性25例,恶性34例,灵敏度67.39%,特异度76.92%,准确率69.49%;SMI诊断良性20例,恶性39例,灵敏度80.43%,特异度84.62%,准确率81.36%;CEUS诊断良性28例,恶性31例,灵敏度60.87%,特异度76.92%,准确率64.41%;多模态超声诊断良性13例,恶性46例,灵敏度93.48%,特异度76.92%,准确率89.83%。ROC曲线分析结果显示,CDFI、SMI、CEUS鉴别诊断肾实性肿块良恶性的曲线下面积(AUC)分别为0.722、0.825、0.689,多模态超声鉴别诊断的AUC为0.852。结论多模态超声对肾实性肿块良恶性的鉴别诊断具有一定的临床应用价值。Objective To explore the clinical application value of CDFI,superb microvascular imaging(SMI)and contrast-enhanced ultrasound(CEUS)in the differential diagnosis of benign and malignant renal solid masses.Methods Totally 59 patients with renal solid masses confirmed by pathology in our hospital were selected,including 13 cases were benign and 46 cases were malignant,all underwent CDFI,SMI and CEUS examination.The sensitivity,specificity and accuracy of each examination method and multimodal ultrasound in the differential diagnosis of benign and malignant renal solid masses were compared.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of each examination method and multimodal ultrasound in the differential diagnosis of benign and malignant renal solid masses.Results Among 59 patients,CDFI diagnosed 25 cases was benign and 34 cases was malignant,with a sensitivity of 67.39%,a specificity of 76.92%,and an accuracy of 69.49%.SMI diagnosed 20 cases was benign and 39 cases was malignant,with a sensitivity of 80.43%,a specificity of 84.62%,and an accuracy of 81.36%.CEUS diagnosed 28 cases was benign and 31 cases was malignant,with a sensitivity of 60.87%,a specificity of 76.92%,and an accuracy of 64.41%.Multimodal ultrasound diagnosed 13 cases was benign and 46 cases was malignant,with a sensitivity of 93.48%,a specificity of 76.92%,and an accuracy of 89.83%.ROC curve analysis results showed that the area under the curve(AUC)for CDFI,SMI and CEUS alone in the differential diagnosis of benign and malignant renal solid masses were 0.722,0.825 and 0.689,respectively.The AUC for multimodal ultrasound was 0.852.Conclusion Multimodal ultrasound has a certain clinical application value in the differential diagnosis of benign and malignant renal solid masses.

关 键 词：超声检查 彩色 多普勒 造影剂 超微血管成像 肾实性肿块 良恶性 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]