超声造影和增强CT在肾实质良恶性病灶诊断中的应用比较

Comparison of contrast-enhanced ultrasound and contrast-enhanced CT in differential diagnosis of benign and malignant renal parenchyma lesions

目的比较超声造影和增强CT在诊断肾脏实质内病灶良、恶性中应用价值。方法对60例患者共61个临床诊断为肾脏实质内占位性病灶进行超声造影(CEUS)和增强CT(CECT)检查,通过分析病灶CEUS和CECT各个时相中的灌注特点,比较两种方法的诊断效能。结果61个病灶中39个为肾脏恶性肿瘤,22个为肾脏良性病灶,CEUS和CECT诊断敏感性、特异性、准确性、阳性预测值和阴性预测值分别为97.44%、90.91%、95.08%、95.00%、95.24%与89.74%、81.82%、86.89%、89.74%、81.82%。两种方法诊断效能差异无统计学意义(P>0.05)。结论CEUS和CECT在诊断肾脏良恶性病灶中,具有相似的敏感性和准确性,但CEUS在鉴别肾脏结构异常和反映肿瘤微循环灌注方面优于CECT。

Objective To evaluate the value of contrast-enhanced ultrasound （CEUS） and contrast-enhanced CT （CECT） in diagnosis of benign and malignant renal parenchyma lesions. Methods A total of 60 patients underwent CEUS and CECT respectively. The diagnostic efficiency of two techniques were compared by evaluating the perfusion features of different phase. Results Among 61 renal lesions in 60 patients, 39 lesions were malignant and 22 were benign. Overall diagnostic sensitivity, specificity, diagnostic accuracy was 97. 44%, 90.91%, 95.08% for CEUS and 89.74%, 81.82%, 86. 89% for CECT, respectively. Positive predictive value and negative predictive value of CEUS and CECT in diagnosis of renal malignant tumor was 95.00%, 95. 24% and 89.74%, 81.82%, respectively. Conclusion There is no statistical difference in the sensitivity and the accuracy between CEUS and CECT in diagnosis of benign and malignant renal parenchyma lesions. However, CEUS is better than CECT in diagnosis of abnormal renal parenchyma structure and the microcirculation perfusion.