超声造影对鉴别诊断肾囊性病灶良恶性的价值

The value of contrast-enhanced Ultrasonography in differentiation of cystic renal mass

目的探讨超声造影对鉴别诊断肾囊性病灶良恶性的价值。方法对39例45个肾囊性病灶(22个病灶为病例组,23个病灶为对照组)进行彩色多普勒超声及超声造影检查。比较彩色多普勒超声与超声造影显示肾囊性病灶内部血流信号、分隔及实性结节的不同。并将彩色多普勒超声与超声造影的结果与金标准进行对照,计算并比较2种方法的敏感性、特异性、漏诊率、误诊率、准确性、阳性预测值、阴性预测值、阳性似然比、阴性似然比。结果超声造影较彩色多普勒超声能更清晰显示肾囊性病灶内复杂结构,血流显示率由44.4%提高至77.8%。超声造影与彩色多普勒超声相比具有更高的敏感性(91.0%和68.2%)、特异性(95.5%和73.9%)和诊断准确性(93.3%和71.7%)。结论超声造影较彩色多普勒超声能更敏感检出肾囊性病灶血流、分隔及实性结节,是一种简便、安全的鉴别肾囊性病灶良恶性的方法。

Objective To evaluate contrast-enhanced Ultrasnonography（CEUS） in differentiation of cystic renal mass.Methods Thirty-nine patients with 45 lesions（22 lesions were case group,23 lesions were control group） were studied.The features of color doppler flow imaging（CDFI） and CEUS of the cystic renal,including septa,solid node and blood perfusion were compared.The sensitivity,specificity,misdiagnosis rate,accuracy,positive predictive value,positive likelihood ratio,negative likelihood ratio of two methods were calculated respectively.Results The more details of renal cystic lesions were detected by CEUS than by CDFI.The ability to detect blood increase from 44.4% using CDFI to 77.8% using CEUS.Compared with CDFI,CEUS had higher sensitivity（91% vs 68.2%）,specificity（95.5% vs 73.9%） and accuracy（93.3% vs 71.7%）.Conclusion CEUS is simple and non-radiation exam to differentiate the cystic renal mass because of its higher sensitivity for detection the septa,solid nodules and blood perfusion compared to CDFI.