肾脏巨大错构瘤的超声诊断探讨

Discussion on the diagnosisudy of giant renal hamartoma with color Doppler ultrasound

目的探讨彩色多普勒超声诊断肾脏巨大错构瘤(最大径线大于10cm)的临床应用价值。方法回顾性分析经手术病理证实的9例肾脏巨大错构瘤的超声检查资料,并对其超声表现特征进行分析。结果 9例肾脏巨大错构瘤超声诊断正确7例(77.78%),1例误诊为肾癌(11.11%),1例误诊为肾上腺脂肪瘤(11.11%)。肾脏巨大错构瘤的声像大致呈椭圆形,轮廓清晰,6例呈高回声,2例呈中等回声,1例呈低回声。高回声及中等回声肿块内皆观察到了高低回声相间的"条纹征",且肿块内血流稀少。低回声肿块内未见"条纹征",血流较多。9例肾脏巨大错构瘤皆观察到了肿瘤的外突部分对肾脏形成的"挤压征"。2例肾脏巨大错构瘤因破裂出血在局部可见无回声区。6例在双肾实质内见到多发高回声小错构瘤征象。结论肾脏巨大错构瘤的声像图表现有一定的特征性,超声对肾脏巨大错构瘤的诊断具有重要价值,可作为术前检查的首选方法。

Objective To discuss the value of color Doppler ultrasound on the diagnosis of giant （larger than 10cm） renal hamartoma （GRH）. Methods Ultrasonic images of 9 cases with GRH confirmed by pathology after operation were retrospectively studied. Results 7 cases were diagnosed correctly by ultrasound （7/9）, 1 case were mistaken as renal carcinoma （1/9） and 1 case was mistaken as adrenal gland fat tumor （1/9） in ultrasound diagnosis. The GRH shape was ellipse with clear margins. The GRH were showed high echo in 6 cases, middle echo in 2 cases and low echo in 1 case. That high alternate with low echoes were composed ＂stripe sign＂ were observed in all high echo and middle echo GRH, and there were a few bloodstream signal in these masses. The low echo GRH were not observed ＂stripe sign＂, and there were more bloodstream signal. That the protruding parts of GRH pressed the kidneys to form ＂press sign＂ were observed in all cases. The GRH with spontaneous rupture were observed cystic area in 2 cases. Both kidneys had many high echo small hamartoma sign in 6 eases. Conclusion The GRH has some features in ultrasonic images, color Doppler ultrasound has important diagnostic value for GRH, it could be considered as the first diagnostic method before operation.