三维超声造影对肾良恶性肿瘤的鉴别诊断

Differential diagnosis between renal benign and malignant tumors with three-dimensional contrast-enhanced ultrasound

目的 探讨三维超声造影对肾良恶性肿瘤的鉴别诊断价值.方法 对68例肾良恶性肿瘤进行常规超声及二维超声造影检查,在此基础上行三维重建,并与二维造影进行对比,分析三维超声造影对肾良恶性肿瘤的鉴别诊断价值及表现.所有病例均经手术病理证实.结果 肾良性肿瘤18例,二维造影多表现为等增强或低增强,呈＂慢进慢出＂;三维造影表现为病灶内较少的平直规则的周边血管和内部血管.肾恶性肿瘤50例,二维造影多表现为高增强,呈＂快进快出＂;三维造影多表现为病灶内多支蜿蜒扭曲的周边血管和内部紊乱的微小血管组成的血管网.三维超声造影可直观立体显示肿瘤血管分布特征,在显示肿瘤血管方面优于二维超声造影（P＜0.05）.结论 三维超声造影可显示肾肿瘤血管特征及其空间分布,对鉴别肾肿瘤的良恶性有重要的实用价值.

Objective To assess the differential diagnosis and characteristics of renal benign and malignant tumors with three-dimensional contrast-enhanced ultrasound （3D-CEUS）. Methods Totally 68 patients with renal tumors were examined by conventional ultrasound and two-dimensional contrastenhanced ultrasound（2D-CEUS）. 3D imaging was reconstructed from 2D imaging, the differential diagnosis of renal tumors with 3D-CEUS was analyzed by comparing with 2D-CEUS. All patients with renal tumors were proved by operational pathology. Results Eighteen patients with renal benign tumors mostly displayed equal or low enhancement, showed ＂slowly in and slowly out＂ with 2D-CEUS, while displayed regular peripheral and internal vessels with 3D-CEUS. Fifty patients with renal malignant tumors mostly displayed high enhancement, showed ＂rapidly in and rapidly out＂ with 2D-CEUS,displayed winding peripheral vessels and disordered internal vessels with 3D-CEUS. 3D-CEUS may display the vascular characteristics of tumors and showed superior imaging quality to 2D-CEUS （ P 〈 0.05）. Conclusions 3D-CEUS can display the vascular characteristics of tumors and their spatial positions, it plays an important role in differential diagnosis between renal benign and malignant tumors.