B超对肾肿瘤的定性诊断及误诊原因分析

An analysis of diagnosis and misdiagnosis of type-B ultrasound in renal tumors

目的：分析B超诊断肾肿瘤的误诊原因，旨在降低误诊率，为肾肿瘤患者的早期治疗提供信息。方法将2011年8月~2013年8月于我院接受手术治疗且经病理诊断证实为肾肿瘤的50例患者作为研究对象，患者入院后均实施定性B超诊断及超声造影检查，与术后病理结果对照，记录B超诊断的检出率，并分析误诊原因。结果（1）B超诊断出肾细胞癌22例，符合度为59.09%，肾盂癌10例，符合度为40.00%，肾错构瘤11例，符合度为27.27%。其中以肾细胞癌诊断符合度最高，明显高于肾盂癌与肾错构瘤，组间对比差异有统计学意义（x2=12.368，P＜0.05）；（2）相较CT与肾动脉造影来说，B超诊断检查符合度比较低，仅为46.51%，且未确定率与不符合率明显高于CT及肾动脉造影诊断。结论临床上，为提高肾癌患者的检出率，降低误诊率，可联合多种检测方式进行综合诊断。

Objective To analyze diagnosis and misdiagnosis of type-B ultrasound in kidney cancer, and aim at reducing the rate of misdiagnosis, to provide information for early treatment of patients with kidney cancer. Methods 50 cases of patients received surgery and confirmed by pathological diagnosis of renal tumors in our hospital from August 2011 to August 2013 were selected as the object of observation, all the patients in hospital were implemented the exam of qualitative type-B ultrasound diagnosis and ultrasound imaging, and were compared with postoperative pathological findings, the type-B ultrasound diagnostic relevance rate was recorded, and the causes of misdiagnosis was analyzed. Results （1）22 cases of renal cell carcinoma were diagnosed by Type-B ultrasound, its conformity rate was 59.09%; 10 cases of renal pelvis cancer were diagnosed, its conformity rate was 40.00%; renal angiomyolipoma in 11 cases, the conformity rate was 27.27%. The conformity rate of diagnosis of renal cell carcinoma was the highest among them, significantly higher than renal pelvis cancer and renal angiomyolipoma, the differences between these groups was significant （x2=12.368, P〈0.05）;（2）CT angiography and renal artery angiography were compared, type-B ultrasound diagnosis conformity rate was relatively low, only 46.51%, uncertain rate and no-coincidence rate was significantly higher than CT angiography and renal artery imaging. Conclusion In order to improve the detection rate and reduce the rate of misdiagnosis of patients with kidney cancer in clinic, a comprehensive diagnosis can combined with a variety of detection methods.