超微血流成像技术在肾肿瘤良恶性鉴别诊断中的应用价值  

Value of Ultrasound Micro vascular Angiography in Differential Diagnosis between Benign and Malignant Renal Tumors

作　　者：程睿 王颖[1] 李思思 魏丽 黄韵琳 曹司琪 曹佳颖 程娟[1] 董怡 CHENG Rui;WANG Ying;LI Sisi;WEI Li;HUANG Yunlin;CAO Siqi;CAO Jiaying;CHENG Juan;DONG Yi(Department of Ultrasound,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院超声科,上海200092

出　　处：《中国医学计算机成像杂志》2025年第1期113-116,共4页Chinese Computed Medical Imaging

基　　金：国家自然科学基金面上项目(82071942);国家自然科学基金NSFC-德国研究联合会DFG中德合作交流项目(M-0504);上海市浦江人才计划(2020PJD008)。

摘　　要：目的:评估超微血流成像(UMA)对肾肿瘤良恶性的诊断及鉴别诊断的价值。方法:前瞻性收集就诊于我院诊断为实质性肾肿瘤拟行手术切除的患者。应用彩色多普勒成像(CDFI)及UMA技术,评估肾肿瘤内部的血管形态和血流分级。以手术及术后组织病理学结果为金标准,对比评估CDFI及UMA鉴别诊断肾肿瘤良恶性的价值。结果:自2023年12月至2024年4月,本研究最终纳入32例患者,其中恶性肾肿瘤27例,良性肾肿瘤5例。UMA技术中,减影超微血流成像(sUMA)模式在显示肾肿瘤内部微小低速血流方面最为灵敏,其根据血管形态和Alder血流分级诊断恶性肾肿瘤的受试者工作特征曲线下面积(AUC)分别为0.87和0.70,明显优于CDFI(AUC分别为0.57和0.55)。结论:sUMA有助于无创、灵敏、直观地显示肾肿瘤内部微小低速血流信号,为肾肿瘤术前无创的诊断及鉴别诊断提供必要信息。Purpose:To assess the value of ultrasound microvascular angiography(UMA)for the differential diagnosis between benign and malignant renal tumors.Methods:In this prospective study,patients diagnosed with renal tumors and intended for surgical resection in our hospital were included.Color Doppler flow imaging(CDFI)and UMA were applied to assess the vascular morphology and blood supply within the renal tumor.Taking surgical resection and histopathological results as the gold standard,the value of UMA and CDFI for differential diagnosis of benign and malignant renal tumors was compared.Results:From December 2023 to April 2024,32 patients with 27 malignant and 5 benign tumors were finally included in this study.Among the UMA technique,sUMA imaging modality was the most sensitive in displaying low-velocity blood flow.Based on the morphologic patterns of vessels and Alder semiquantitative grading,the area under the receiver operating characteristic curve(AUC)of subtraction UMA(sUMA)for diagnosing malignant renal tumors were 0.87 and 0.70,respectively,which were significantly better than that of CDFI(AUC=0.57,0.55).Conclusions:Tiny low-velocity blood flow signals of renal tumors can be displayed by sUMA sensitively,which could support the preoperative non-invasive diagnosis and differential diagnosis of renal tumors.

关 键 词：肾肿瘤 超微血流成像 半定量分析 诊断 鉴别诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]