超声造影技术在肾癌诊断中的临床应用价值

Evaluation of renal carcinoma with contrast-enhanced ultrasound

目的研究超声造影成像技术对肾癌的临床诊断价值。方法对21例经手术病理证实的肾脏恶性肿瘤(肾细胞癌18例,肾盂癌3例)患者进行超声造影观察,分析其造影增强图像特点,并与增强CT对照分析。结果所有患者均获得清晰的肿瘤动态造影灌注图像。18个(100%)肾细胞癌病灶在超声造影(CEUS)和增强CT(CECT)皮质期均显示全瘤增强,CEUS及CECT表现为高增强分别为14个(77.8%)和16个(88.9%,P>0.05),等增强分别为4个(22.2%)和2个(11.1%,P>0.05)。造影剂早于肾皮质消褪者在CEUS和CECT分别为13个(72.2%)和15个(83.3%),与肾皮质同步消褪分别为5个(27.8%)和3个(16.7%),两者无显著性差异。3例肾盂癌在超声造影及增强CT均呈全瘤强化,造影强度与肾皮质相同,较肾皮质提前消褪。结论超声造影成像技术能清晰显示肾癌的血流灌注特点,为临床提供了一种简便易行的肾癌诊断手段。

Objective To ascertain the value of contrast-enhanced imaging features in the diagnosis of renal carcinoma,compared with contrast-enhanced computed tomography（ CECT ）. Methods CEUS and CECT were carried out in 21 patients with surgery and pathology proved malignant neoplasm of kidney, ineluding renal cell carcinoma （ n= 18 ） and renal pelvic carcinoma （ n=3 ）. The characteristics of CEUS and CECT were analyzed retrospectively. Results clear real-time dynamic enhanced tumor perfusion images were obtained in all of the 21 patients. All of the 18 renal cell carcinoma lesions （100%） showed enhance- ment on CEUS and CECT in renal cortex phase. The number of the lesions with hyperor iso-enhancing on CEUS and CECT was 14 （77.8%） and 16 （88.9%）, 4（22.2%） and 2 （11.1%）,respectively （P〉0.05） .In washout phase, the number of the lesions earlier than renal cortex phase on CEUS and CECT was 13 （72.2%） and 15 （83.3%）, respectively （P〉0.05）. The enhanced features of all three renal pelvic carcinoma on CEUS and CECT were completely enhanced, their wash-out time was earlier than that of renal cortex. Conclu- sion The enhancement pattern of renal carcinoma on CEUS was consistent with that on CECT, whereas CEUS has the advantages of easy performance, real-time scanning and readily available.