彩色多普勒血流成像在恶性肾实质上皮性肿瘤诊断中的价值

The value of color Doppler flow imaging in the diagnosis of malignant renal parenchyma epithelial tumour

目的探讨彩色多普勒血流成像(CDFI)在恶性肾实质上皮性肿瘤(MRPET)诊断中的应用价值。方法将手术病理证实为MRPET的116例患者分为≤4 cm(39例)组和>4 cm组(77例),对比两组患者术前彩色多普勒超声检查结果(患侧肾轮廓有无改变、病变边界、内部回声类型、病变边缘、内部血流分布及其血流强度分级情况),并与手术病理结果对照。结果116例MRPET超声图像特征:(1)二维超声:≤4 cm组肿瘤内部偏高回声检出率66.7%(26/39)高于>4 cm组5.2%(4/77),而肿瘤内部混合性回声检出率5.1%(2/39)明显低于>4 cm组79.2%(61/77),两组肿瘤内高回声及混合回声检出率比较差异有非常显著性(P均<0.01)。两组肿瘤病变均显示肾轮廓改变;(2)彩色多普勒超声:116例肿瘤内探及彩色血流信号105例(90.5%,105/116),其中69例(59.5%)肿瘤内部及周边见丰富的Ⅲ级彩色血流信号;≤4 cm组肿瘤内部Ⅲ级血流检出率为35.9%(14/39),>4 cm组肿瘤内部Ⅲ级血流检出率为71.4%(55/77),两组比较差异有非常显著性(P<0.01)。术前超声诊断MRPET与病理诊断符合率93.1%(108/116)。结论CDFI在MRPET术前诊断、分期及临床治疗中有重要的作用。

Objective To evaluate the value of color Doppler flow imaging（CDFI） in the diagnosis of malignant renal parenchyma epithelial tumour （MRPET）. Methods CDFI was taken to examine 116 cases of pathologically diagnosed with MRPET which were classified into ≤4 cm group （39 cases） and 〉4 cm group （77 cases）. The renal vallate change, boundary of lesion, internal echo intensity, blood flow distribution and intensity of periphery and interior of lesion were observed. According to the sizes of lesions. The results of CDFI were compared with those of pathology after operation. Results The characteristics of ultrasound imaging of 116 cases was ： （ 1 ） Echoes ： Meta-hyperechogenicity was observed in 66.7% （26/39） cases of ≤4 cm group, highly than that of 〉4 cm group （5.2% ,4/77） （ P 〈0.01 ） . Mixed echoes were shown in 79.2% （61/77）cases of 〉4 cm group, highly than that of ≤4 cm group （5.1% ,2/39） （P 〈 0.01 ） . Both ≤4 cm and 〉4 cm groups showed renal vallate change. （2） CDFI： Color blood flow was detected in 90.5% （105/116） cases and Ⅲ stage color blood flow was detected in periphery and intetior of lesions of 59.5% （69/116） cases. Displaying rate of Ⅲ stage color blood flow was 71.4% （55/77） in 〉 4 cm group, highly than that of ≤4 cm group which was 35.9% （ 14/39 ,P 〈 0.01 ） . The results of pathology after operation showed accuracy of ultrasonography in MRPET before operation was 93.1% （108/116）. Conclusion CDFI played an important role in diagnosis before operation, stage and clinical treatment of MRPET.