肾透明细胞癌诊断中超声造影的应用价值(附42例报告)

Diagnosis of Renal Clear Cell Carcinoma of the Application of the Value of Contrast-enhanced Ultrasound

目的探讨超声造影在肾透明细胞癌诊断中的应用价值。方法对病理结果为肾透明细胞癌的42例患者的超声造影结果进行回顾性分析,对肾透明细胞癌超声造影模式进行分型,并与病理分化程度进行对照研究。结果肾透明细胞癌超声造影模式分四型:Ⅰ型:快进快出型14例,Ⅱ型:快进慢出型9例,Ⅲ型:同进同出型9例,Ⅳ型:慢进慢出型10例,前三型病理组织学表现为分化程度较低,血管成分及血管弹力层纤维丰富,间质成分较少;Ⅳ型病理组织学表现为分化程度较高,间质成分较多,血管成分较少。结论超声造影在肾透明细胞癌的诊断方面有一定的应用价值。

Objective To evaluate the relationship between contrast- enhanced ultrasound（CEUS）pattern of renal clear cell carcinoma and tumor pathologic differentiation. Methods Fouty two clear cell carcinoma lesions with pathologic result were examined on pulsed subtraction CEUS with a bolus injection of SonoVue. Using the machine -drawn CnTI（ contrast tuned imaging）and time- intensity curves,The CEUS results were analysed retrospectively. Results Enhancement pattern of renal clear cell carcinoma were divided into four models. Fouteen cases with type Ⅰ renal clear cell carcinoma result indicated contrast enhancement patterns of fast in and fast out ; nine cases of Ⅱ type and nine cases of Ⅲ type result indicated contrast enhancement patterns of ＂fast in slow out＂ and ＂same in same out＂ ;the degree of pathology - differentiation is low：more vascularity and less mesenchymal. Ten cases of Ⅳ type renal result indicated contrast enhancement patterns of ＂slow in slow out＂ ;in high pathologic differentiated renal clear cell carcinoma, less blood vessel and abundant mesenchymal tissues. Conclusion Contrast enhanced patterns of renal clear cell carcinoma were correlated with tumor pathologic differentiation.