超声造影与多层增强螺旋CT对肾占位性病变诊断价值的对比研究

Comparative study of enhanced ultrasound and contrast-enhanced helical CT in diagnosis of renal masses

目的比较超声造影(CEUS)与多层增强螺旋CT(CECT)对肾占位性病变良恶性的诊断价值。方法回顾性分析2020年9月至2021年3月于哈尔滨医科大学附属第一医院就诊,经病理证实为肾占位性病变的患者48例,均行CEUS及CECT检查,CEUS应用造影剂示卓安(Sonazoid)。以病理结果为金标准,将其分成良性组(10例)及恶性组(38例),采用χ^(2)检验比较2种影像学检查的诊断效能及恶性增强征象在CEUS及CECT中显示率的差异,统计CEUS中正常肾实质增强持续时间。结果高增强、不均匀强化、快进、快出等征象对判断肾恶性肿瘤具有诊断价值。其中高增强在CEUS中的显示率优于CECT(92.11%vs73.68%),差异具有统计学意义(χ^(2)=4.547,P=0.033)。CEUS对肾肿瘤定性诊断具有较高的应用价值,其准确性及特异度高于CECT(95.83%vs93.75%;90.00%vs80.00%),敏感度与CECT一致(97.37%vs97.37%),差异均无统计学意义(P均>0.05)。Sonazoid-CEUS在正常肾实质的增强持续时间为(6.43±1.20)min,其中34例(70.83%,34/48)患者显像时间超过7 min。结论应用示卓安进行CEUS延长了肾肿瘤及肾实质的增强时间,在评估肾肿瘤良恶性方面具有与CECT相似的诊断效能。

ObjectiveTo evaluate the value of contrast-enhanced helical computed tomography(CECT)and enhanced ultrasound(CEUS)in differentiating benign and malignant renal masses.MethodsWe retrospectively analyzed 48 patients with renal masses diagnosed by pathology at the First Affiliated Hospital of Harbin Medical University from September 2020 to March 2021,all of whom underwent CEUS and CECT examinations,and CEUS with Sonazoid.These patients were divided into either a benign group(n=10)or a malignant group(n=38)according to the pathological results.The diagnostic efficacy of the two imaging methods and the difference in the detection rates of malignant enhancement signs between them were compared byχ^(2)test.The mean enhancement duration of Sonazoid-CEUS in normal renal parenchyma was statistically calculated.ResultsHyper-enhancement,inhomogeneous enhancement,fast fill in,and fast wash out showed higher diagnostic value in renal malignant tumors.The positive rate of"hyper-enhancement"in CEUS was obviously higher than that in CECT(92.11%vs73.68%,χ^(2)=4.547,P=0.33).CEUS had high application value in the diagnosis of benign and malignant renal tumors.The accuracy and specificity of CEUS were higher than those of CECT(95.83%vs93.75%;90.00%vs80.00%),and its sensitivity was the same as that of CECT(97.37%vs97.37%),the differences were not statistically significant(P>0.05).The mean duration of Sonazoid-CEUS enhancement in normal renal parenchyma was(6.43±1.20)min,with 34 patients(70.83%,34/48)exceeding 7 min.ConclusionCEUS with Sonazoid prolongs the enhancement time of renal tumors and renal parenchyma.It has similar diagnostic efficacy to CECT in the assessment of benign and malignant renal tumors.