超声造影诊断肾盂癌

Contrast-enhanced ultrasonographic diagnosis of renal pelvic carcinoma

目的探讨超声造影(CEUS)诊断肾盂癌的潜在价值。方法对22例经手术病理证实为肾盂癌患者的常规超声及CEUS声像图进行回顾性分析。常规超声观察肾占位大小、回声、边界、有无彩色血流信号。CEUS观察肿块的增强时相和增强方式,包括肿块的增强、消退时间和灌注表现。结果本组22个肿块直径范围1.5～8.5 cm。常规超声显示扁平样肿块7个,不规则团块样肿块15个;伴同侧肾脏积水11例。5个肿块内发现较丰富彩色血流信号,9个仅周边少量彩色血流信号,8个未显示彩色血流信号。CEUS显示皮质期22个肿块均增强;同步增强8个,缓慢增强14个;达峰值呈低回声18个,高回声3个,等回声1个;实质期快速消退20个,同步消退1个,缓慢消退1个。常规超声和CEUS的诊断准确率分别为63.64%(14/22)和81.82%(18/22)。结论CEUS可改善肾盂癌的血供显示,提高诊断率。

Objective To explore the potential value of contrast-enhanced ultrasonography（CEUS） in diagnosis of renal pelvic carcinoma.Methods The ultrasonogram of conventional ultrasound and CEUS were analyzed retrospectively in 22 patients of renal pelvic carcinoma proved pathologically.The size,echo,boundary and color flow signal of renal pelvic lesions were observed with conventional ultrasound.The enhancement modality and phase of tumors were also observed with CEUS,including wash-in and wash-out time,as well as the perfusion appearances.Results The maximum diameters ranged from 1.5 cm to 8.5 cm in 22 renal pelvic tumors.Conventional ultrasound detected flat mass in 7 tumors,irregular mass in 15 tumors;the same side hydronephrosis in 11 patients.Color Doppler flow imaging（CDFI） disclosed fairly rich flow signal of 5 tumors,a small amount of flow signal around tumor in 9 tumors and no-flow signal in the rest tumors.CEUS detected the cortical phase enhancement in all renal pelvic tumors,including synchronously enhancement in 8 tumors and delayed enhancement in 14 tumors.In peak time,hypoechogenicity compared to the normal renal cortex was showed in 18 tumors,hyperechogenicity in 3 tumors and isoechogenicity in 1 tumor.Fast wash-out in medulla phase was displayed in 20 tumors,isochronously wash-out in 1 tumor and delayed wash-out in 1 tumor.The diagnostic accuracy of the conventional ultrasound and CEUS was 63.64%（14/22） and 81.82%（18/22）,respectively.Conclusion CEUS can depict blood flow supply and improve the diagnostic rate of renal pelvic carcinoma.