肾错构瘤超声诊断的临床价值探讨

Study of Clinical Value of Ultrasonography in Diagnosis of Renal Hamartoma

目的:旨在提高超声对肾错构瘤的诊断准确性。材料和方法:接受手术治疗的50例肾肿瘤患者,共手术切除肿瘤63个,均有术后病理结果。仪器:东芝-250、240,GE-3000,西门子-G50,均使用腹部探头,频率3.5-3.75MHz。取左、右上腹部做肋间隙斜切、横切、冠状切位,必要时加做俯卧位背部纵切和横切位。超声检测肿块部位、形态、大小、边界、包膜、内部回声、后方回声。结果:术后病理结果肾错构瘤63个。肿瘤最小直径0.6cm,最大直径13cm。肿瘤边界清52个,有包膜2个,强回声40个,高回声14个,等回声4个,低回声5个,内部回声分布大多均匀51个。超声对肾错构瘤术前诊断准确率为31.75%(20/63)。结论:由于肾错构瘤的组织病理学特性多样,超声声像图表现也各异,这是造成超声医师诊断信心不足的主要原因,超声对肾错构瘤术前诊断准确率有待提高。

Purpose： To improve the diagnostic accuracy of renal hamartoma by ultrasonography. Materials and Methods： Fifty surgically treated patients with renal tumors （63 tumors were involved） which have been proved by pathology. Equipment： Toshiba- 250,240, GE - 3000 and Siemens - G50 with a 3.5- 3.75MHz abdominal probe. We examined both epigastria in inter- costal oblique, transverse and coronary scan. Longitudinal and transverse scan on back in ventricumbent position were also selected when necessary. The location, shape, size, border, capsule, inner and posterior echo of the tumor were assessed. Results： Sixty - three tumors were proved to be renal hamartoma by pathology. The diameters of the tumors were from 0.6 to 13cm. Fifty - two tumors had well - defined borders, 2 tumors had capsules, 40 tumors showed strong echo, 14 ones were hypereehoie, 4 ones were iso- echoic, 5 ones were hypoechoic. Fifty - one tumors showed homogeneous echotextures. The preoperative diagnostic accuracy of renal hamartoma by sonography was 31.75% （20/ 63） .Conclusion： The ultrasonography of renal hamartomas is different since their various histopathologic characteristics. This is the main reason that ultrasonography doctors are not confident of diagnosing. The preoperative diagnosis of renal hamartoma by ultrasonography is need to be advanced.