超声造影对肾肿瘤的诊断价值

The diagnostic value of contrast-enhanced sonography in renal tumors

目的:探讨超声造影对肾肿瘤的诊断价值。方法:对520例占位性病变患者进行常规超声和灰阶超声造影检查,对其中386例经手术或超声引导下肾穿刺活检病理证实的恶性肿瘤288例、良性肿瘤82例和肾柱肥大16例的造影结果进行回顾性分析。结果:超声造影提示肾恶性肿瘤多数表现为"快进快退",其鲜明特征是瘤体呈快速弥漫增强,肾细胞癌(RCC)多伴有假包膜和出血、坏死灶。肾良性肿瘤以血管平滑肌脂肪瘤(AML)为多,多数表现呈"慢进慢退",并以周边向中心、中央向周边缓慢进入退出为其特点。肾柱肥大造影剂显像与正常肾组织一致,整个过程始终无包块轮廓出现,全肾血管走行正常。混合肾囊肿、肾内血肿造影后无造影剂进入,即无增强显示。结论:超声造影能够明确显示有无肾肿瘤的存在,对鉴别肾良恶性肿瘤有较大的实用价值。

Objective： To evaluate contrast-enhanced sonography in the diagnosis of renal tumors. Methods： Five hundred and twenty patients with renal tumors were examined by real time gray-scale enhanced sonography. Results： Of the 520 cases, 288 were diagnosed as malignant tumor, 82 cases as benign tumor and 16 cases as kidney malformation. On contrast-enhanced sonography, fast wash-in and fast wash-off were noted in malignant tumors. Pseudo-capsule and intra-tumoral cyst were noted in some renal cell carcinomas. Enhancement from periphery to center and slow wash-in and slow wash-off were noted in AMLs. Contrast-enhanced imaging in renal cysts and hemorrhagic cysts were not visible on contrast-enhanced sonography. Conclusion： Contrast-enhanced sonugraphy is useful in the differential diagnosis between renal malignant and benign tumors.