囊性肾癌的超声诊断特征及误诊原因分析

The Characteristics and Misdiagnosis Causes of Ultrasound in Diagnosis of Cystic Renal Cell Carcinoma

目的：探讨囊性肾癌（ cystic renal cell carcinoma, CRCC）的超声诊断特征及误诊原因。方法回顾性分析我院经手术病理检查证实的 CRCC 17例的临床及超声检查资料。结果超声检查结果显示17例肿瘤直径1.7～16.0（8.2±0.5）cm；多囊性病变10例,单囊性病变6例,左侧肾单囊性、右侧肾多囊性病变1例。13例诊断为CRCC,4例误诊为肾囊肿,误诊率23.53%。4例误诊病例中3例为较大囊性癌,超声检查显示囊壁规则且较薄,囊壁未见结节性病变,囊腔内为均匀性低回声,囊壁及囊腔均未探及明确血流回声；1例为多囊性肾癌,囊间分隔及囊壁规整且较薄,仅分隔与囊壁交界处的壁稍增厚,彩色多普勒未查及明确血流信号。结论超声检查可为临床早期诊断CRCC提供重要影像学依据。

Objective To explore the characteristics and misdiagnosis causes of ultrasound in diagnosis of cystic renal cell carcinomas （ CRCC） . Methods Clinical and ultrasonic features in 17 patients with CRCC confirmed by operative pathol-ogy were retrospectively analyzed. Results The ultrasound examination results showed that the tumor diameter was ranged from 1. 7 cm to 16. 0 cm and averaged （8. 2 ± 0. 5） cm in the 17 patients. There were 10 patients with multicystic lesion, 6 patients with single cystic lesion, and one patient with single cystic lesion in left kidney and polycystic lesion in right kidney. A total of 13 patients were diagnosed as having CRCC, and 4 patients （23. 53%） were misdiagnosed as having renal cyst. A-mong the 4 patients, 3 had large CRCC, in whose ultrasound results showed regular and thin cyst wall and no nodular lesions, low echo of capsular space, and no clear blood flow echo in both cyst wall and capsular space. For one patient with multicystic lesions, the ultrasound results showed that cyst septum and wall were regular and thin, except the junction of the septum and wall;no blood signal was found. Conclusion Ultrasonography can provide important evidences for early diagnosis of CRCC.