超声造影联合强化CT在肾肿瘤诊断中的临床应用价值

Clinical value of contrast-enhanced ultrasound combined with enhanced CT in the diagnosis of renal tumors

目的探讨超声造影(contrast-enhanced ultrasonography,CEUS)联合强化电子计算机断层扫描(contrast-enhanced computed-tomography,CECT)在肾肿瘤诊断中的临床应用价值。方法选取手术治疗的肾肿瘤患者101例,术前均完善CEUS及CECT检查,并与术后病理结果比较。结果CEUS诊断恶性肿瘤76例(75.2%),CECT诊断恶性肿瘤71例(70.3%),CEUS联合CECT诊断恶性肿瘤74例(73.4%)。CEUS、CECT、CEUS联合CECT诊断与病理诊断恶性肿瘤的阳性率差异均无统计学意义(P>0.05)。以病理结果为金标准,对CEUS、CECT、CEUS联合CECT进行评价,CEUS与CECT联合诊断肾肿瘤的敏感度、特异度、准确度较高。结论CEUS诊断肾肿瘤的敏感度高于CECT;CECT诊断肾肿瘤的特异度和准确度高于CEUS;CEUS与CECT联合可以进一步提高肾肿瘤诊断的敏感度、特异度和准确度;肾肿瘤患者术前常规行CEUS及CECT检查,可提高肾肿瘤诊断的准确度,避免过度医疗。

Objective To explore the clinical application value of contrast-enhanced ultrasonography（CEUS）and contrast-enhanced computed-tomography（CECT）in the diagnosis of renal tumors.Methods Selected 101 patients of the renal tumors who received operation were perfected the CEUS and CECT examination before the operation.The results are compared with the pathological diagnosis.Results The 76 cases（75.2%）was diagnosed as malignant tumors by CEUS,71 cases（70.3%）was diagnosed as malignant tumors by CECT,74 cases（73.4%）was diagnosed as malignant tumors by CEUS combined with CECT.These was no statistics significance of the positive rate difference with diagnosed malignant tumors by CEUS,CECT,CEUS combined with CECT and pathological diagnosis（P〈0.05）.Using pathological result as the gold standard,we evaluate the CEUS,CECT,CEUS combined with CECT.The sensitivity,specificity and accuracy of CEUS and CECT in the diagnosis of renal tumors are higher.Conclusion The CEUS has the higher sensibility than the CECT in renal tumor diagnosis.The CECT has the higher specificity and accuracy than the CEUS.The combination of CEUS and CECT can further improve the sensitivity,specificity and accuracy of renal tumor diagnosis.All of the patiens of the renal tumor should be received the CEUS and CECT examination before opention,can improve the accuracy of renal tumor diagnosis and avoid over treatment.