超声造影在肾细胞癌与肾血管平滑肌脂肪瘤鉴别诊断中的价值

Value of contrast-enhanced ultrasound in differential diagnosis of renal cell carcinoma and renal angioleiomyolipoma

目的:探讨超声造影(CEUS)在肾细胞癌(RCC)与肾血管平滑肌脂肪瘤(RAML)鉴别诊断中的价值。方法:回顾性分析经手术病理证实的53例RCC患者和17例RAML患者的二维灰阶超声、彩色多普勒血流显像(CDFI)和CEUS特征。结果:RCC的二维灰阶超声特征以低回声为主,RAML则以高回声为主(P<0.01),但两者的病灶长径、边界、形态和回声均匀性间差异均无统计学意义(P>0.05);RCC的CDFI检查分级以Ⅱ～Ⅲ级为主,而RAML以0～Ⅱ级为主,但两者间差异尚无统计学意义(P>0.05);CEUS特征比较,RCC组与RAML组间患者病灶检查所显示的灌注程度、灌注均匀性和有无环状灌注的差异有统计学意义(P<0.01)。结论:CEUS在RCC与RAML的鉴别诊断中具有重要的临床价值。

Objective To assess the value of contrast-enhanced ultrasound in the differential diagnosis of renal cell carcinoma（RCC） and renal angioleiomyolipoma（RAML）.Methods A retrospective analysis of seventy patients including fifty-three RCCs and seventeen RAMLs was performed.All patients were evaluated by traditional gray-scale ultrasonography,color Doppler ultrasonography and contrast-enhanced ultrasonography and compared with the results of pathology.Results Most RCCs were hypoechoic while RAMLs were hyperechoic（P0.01）,and there was no statistically significant difference in long diameter,boundary,shape and homogeneity（P0.05）.Color Doppler ultrasonography showed no statistically significant difference in characteristics between RCCs and RAMLs（P0.05）.In contrast enhanced ultrasonography,there were significant differences in perfusion level,perfusion homogeneity and existence of circular perfusion between the two groups（P0.01）.Conclusions Contrast-enhanced ultrasonography is valuable in the differential diagnosis of renal cell carcinoma and renal angioleiomyolipoma.