超声造影鉴别诊断肾脏占位性病变的价值

The Value of Contrast-enhanced Ultrasound in the Differential Diagnosis of Renal Lesions

目的:探讨超声造影鉴别诊断肾脏占位性病变的意义。材料和方法:对29例肾脏占位性病变进行超声造影检查。观察并分析良、恶性病变的超声造影表现及灌注特征。结果:肾脏恶性病灶造影剂退出时间多早于肾实质(15/16);其中,肾透明细胞癌在造影晚期多表现为病灶周边环状强回声带(8/11)。肾脏良性病灶中,错构瘤6例造影剂退出与肾实质相似,5例晚于肾实质,与肾脏恶性病灶存在显著性差异(P<0.05);1例肾嗜酸细胞瘤及1例中胚叶肾瘤造影开始减退时间早于肾实质,造影晚期亦可见病灶周边环状强回声带,难以与肾恶性病灶鉴别。结论:超声造影能够实时观察肾脏占位性病变的血流灌注情况,对肾占位性病变的诊断及鉴别诊断具有一定的临床意义。

Purpose： Contrast enhanced ultrasound（CEU） was known of additional diagnostic value. The aim of the current study was to evaluate the significance of contrast-enhanced ultrasound in the differential diagnosis of local renal lesions. Materials and Methods： 29 cases of local renal lesions were examined by contrast-enhanced ultrasound. The characteristics of local lesions in CEU were observed. Resuits： Most of the malignant renal lesions were rich in blood supply with earlier wash-out of contrast agent than the renal parenchyma. Most renal clear cell carcinoma （8/11） showed a strong echo ring around the lesions in the late phase of CEU. The contrast agent washed out from hamartomas at the same speed as（6/11 ） or later than（5/11 ） renal parenchyma. One renal oncocytoma and one mesoblast adenoma also showed strong echo ring in the late phase of CEU. Conclusion： The kinetics of blood supply to renal lesions can be observed with contrastenhanced ultrasound, which had important clinical significance in the differential diagnosis of renal lesions.