CEUS鉴别诊断肾实质实性良、恶性病变

CEUS in differential diagnosis of benign and malignant solid renal parenchymal lesions

目的探讨CEUS在鉴别肾实质实性良、恶性病灶中的价值。方法回顾性分析84例患者的85个肾实质实性病灶的CEUS特征,观察良、恶性病灶的CEUS表现。结果恶性病灶主要表现为增强高于周围肾实质(34/59,57.63%)、不均匀增强(46/59,77.97%)及边界清(52/59,88.14%);而良性病灶主要表现为与周围肾实质相等的增强(15/26,57.69%)、均匀增强(20/26,76.92%)及边界不清(20/26,76.92%),差异均有统计学意义(P均<0.01)。根据增强后边界清晰诊断恶性病灶的阴性预测值(20/27,74.07%)和准确率(72/85,84.71%)均较高,而以病灶周边高增强环诊断恶性病灶的阳性预测值较高(39/39,100%)。部分病灶有特殊CEUS灌注模式。结论 CEUS有助于鉴别诊断肾实质实性良、恶性病灶。

Objective To investigate the differential efficacy of CEUS for benign and malignant solid renal parenchymal lesions（SRPL）.MethodsCEUS features of 84 SRPL patients with 85 lesions were retrospectively analyzed,and the relation of CEUS features to benign and malignant lesions were evaluated.ResultsMalignant lesions tended to hyper enhanced（34/59,57.63%） and were heterogeneous（46/59,77.97%） with sharp edges（52/59,88.14%）,while most benign lesions isoenhanced（15/26,57.69%） and were homogeneous（20/26,76.92%） with unclear edges（20/26,76.92%,P〈0.01）.The feature of sharp edge had both higher negative predictive value（20/27,74.07%） and accuracy（72/85,84.71%） of malignant SRPL,and the feature of perilesional hyper-enhancement rim reached the positive predictive value of 100%（39/39）.Some lesions had special enhancement mode.ConclusionCEUS are helpful to the differential diagnosis of benign and malignant SRPL.