超声造影对肾脏占位性病变的应用研究

Applied research of CEUS for space occupying lesion of kidney

目的:探讨超声造影对于肾脏占位性病变的诊断价值。方法:回顾性分析116例经病理或临床确诊的肾脏占位性病变患者的超声造影图像特征,分析不同时相病变的增强程度以及超声造影对肾脏恶性病变的诊断效能。结果:在116例肾脏占位性病变中恶性病变55例,良性病变61例。超声造影时,肾透明细胞癌在皮质期多表现为高增强,周边环状增强和内部不均匀增强,而血管平滑肌脂肪瘤以低增强多见,两者间差异有统计学意义(x^2=25.94,P<0.05)。在61例良性病变中,15例肾脏囊肿性病变经超声造影分为BosniakⅠ级3例、Ⅱ级5例、ⅡF级6例和Ⅲ级1例。以皮质期病灶高增强和(或)等增强、周边环状增强和(或)不均匀增强作为诊断条件,超声造影诊断肾脏恶性病变的灵敏度、特异度和准确率分别为87.3%、85.2%和86.2%。结论:超声造影对肾脏实性及囊性占位性病变具有重要诊断价值。

Objective To explore the diagnostic value of contrast-enhanced ultrasound （CEUS） in space-occupying lesions of kidney. Methods： The imaging features of CEUS of 116 cases with space-occupying lesions of kidney confirmed by pathology or clinical diagnosis were retrospectively analyzed. The enhancement degree of lesions in different phases and the diagnostic efficiency of CEUS for malignantly renal lesions were analyzed. Results： 116 cases of space-occupying lesions of kidney included 55 malignant lesions and 61 benign lesions. CEUS showed high enhancement, peripheral ring enhancement and heterogeneous enhancement occurred in cortical phase of clear cell carcinoma of kidney, while low enhancement commonly was found in angiomyolipoma, the difference between them was significant （χ^2=25.94, P〈0.05）. In 61 cases with benign lesion, 15 cases with cystic lesions of kidney were divided into Bosniak class I （3 cases）, grade II （5 cases）, grade II F （6 cases） and grade III （1 case） by CEUS. The sensitivity, specificity and accuracy of CEUS in the diagnosis on malignant lesions of kidney were 87.3%, 85.2% and 86.2%, respectively as the diagnostic standards included high and （or） equal enhancement of lesion in cortical phase and peripheral ring enhancement and （or） heterogeneous enhancement. Conclusion： CEUS has important diagnostic value for solid and cystic lesions of kidney.