常规超声联合超声造影对肾上腺肿瘤的诊断价值

Diagnostic value of conventional ultrasound combined with contrast-enhanced ultrasound in adrenal tumor

目的探讨常规超声联合超声造影对肾上腺肿瘤的诊断价值。方法选取经手术病理确诊的肾上腺肿瘤患者60例,术前行常规超声和超声造影检查,分析其声像图特征。以手术病理结果为金标准,绘制受试者工作特征(ROC)曲线分析常规超声和超声造影单独及联合应用对肾上腺肿瘤的诊断价值。结果60例肾上腺肿瘤患者,常规超声确诊53例,其中30例腺瘤平均直径(23.14±4.61)mm,内部呈均质细点状回声,边界光滑、整齐,包膜完整;15例嗜铬细胞瘤平均直径(56.74±4.51)mm,内部呈均匀低回声,边界呈清晰较高回声;8例髓样脂肪瘤平均直径(38.42±4.62)mm,呈圆形均质回声,形态规则、边界清。60例肾上腺肿瘤患者,超声造影确诊57例,32例腺瘤声像图表现为病灶周围均匀增强,内部见散在造影剂;19例嗜铬细胞瘤内均有造影剂填充,多呈明显增强,为富血供病灶;6例髓样脂肪瘤声像图表现为病灶不均匀增强,中央高而周边回声低;常规超声联合超声造影诊断肾上腺肿瘤的敏感性为91.25%,特异性为90.33%,曲线下面积为0.931,均高于单独常规超声和超声造影(均P<0.05)。结论常规超声和超声造影均能准确诊断肾上腺肿瘤,两者联合应用能提高诊断准确率。

Objective To explore the diagnostic value of conventional ultrasound combined with contrast-enhanced ultrasound in adrenal tumor.Methods Sixty patients with adrenal tumor diagnosed by surgical pathology were selected.Conventional ultrasound and contrast-enhanced ultrasound were performed before surgery to analyze their ultrasound characteristics.The results of conventional ultrasound and contrast-enhanced ultrasound were compared with the results of surgical pathology,and the receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of conventional ultrasound,contrast-enhanced ultrasound and their combination in adrenal tumor.Results Of the 60 adrenal tumor patients,53 cases were diagnosed by conventional ultrasound.The average diameter of 30 cases of adenoma was(23.14±4.61)mm,with homogeneous and fine point echoes inside,smooth and neat boundary and a complete envelope.The average diameter of 15 cases of pheochromocytoma was(56.74±4.51)mm,the interior showed uniform low-echo and the boundary showed high clear echo.The average diameter of 8 cases of medullary lipoma was(38.42±4.62)mm,with round homogeneous echo,regular morphology and clear boundary.Of the 60 patients with adrenal tumor,57 were diagnosed by contrast-enhanced ultrasound.Thirty-two cases of adenoma showed uniform enhancement around the lesion and scattered contrast agent inside.19 cases of pheochromocytoma were filled with contrast agent,and most of them showed obvious enhancement,which were rich in blood supply.Six cases of myeloid lipoma showed inhomogeneous enhancement with high center and low peripheral echo.The sensitivity and specificity of conventional ultrasound combined with contrast-enhanced ultrasound in the diagnosis of adrenal tumor were 91.25%and 90.33%respectively,area under ROC curve was 0.931,which were higher than those of conventional ultrasound and contrast-enhanced ultrasound alone(all P<0.05).Conclusion Both conventional ultrasound and contrastenhanced ultrasound can accurately diagnose adrenal tumors,and the combined application of them can improve the diagnostic accuracy,which is worthy of clinical application.