超声造影与增强CT诊断肾细胞癌的比较研究

目的:比较研究SonoVue超声造影(CEUS)和增强CT(CECT)在肾细胞癌诊断中的应用价值.方法:对56例肾占位性病变行SonoVue超声造影检查(CEUS组),同时对其中53例行增强CT检查(CECT组).连续、实时、动态观测肾肿瘤及周边肾实质血流灌注情况,记录注射造影剂后皮质期、实质期及延迟期肿瘤增强形态、强化方式,并与CECT增强全过程相比较.结果:CEUS组癌灶增强主要表现为皮质期等增强,实质期、延迟期低或等增强,仅有少部分表现为三期轻微增强.确诊.肾恶性肿瘤42例,误诊4例;确诊良性肿瘤7例,误诊3例.CECT组确诊肾恶性肿瘤38例,误诊5例;确诊良性肿瘤6例,误诊4例.CEUS和CECT诊断肾恶性肿瘤的灵敏度、阳性预测价值、诊断准确率分别为91.3%/88.4%、93.3%/88.4%、87.5%/81.1%.结论:CEUS和CECT都能敏感显示肾细胞癌血供强化特征,在肾细胞癌的定性诊断中起到相互补充的作用.

A comparison study of contrast-enhanced ultrasonography and contrast-enhanced computed-tomography in the diagnosis of renal cell carcinoma.

Objective:To explore and compare the value of contrast-enhanced ultrasonography and contrast-enhanced computed-tomography in the diagnosis of renal cell carcinoma.Methods:We performed CEUS,CECT examination on 56,53 patients with renal neoplasms respectively. The blood perfusion condition of the masses and surronding normal renal parenchyma in a continuous and dynamic way were observed and the enhancement appearnce and patterns of neoplasms in cortical, parenchymal and delayed phase of CEUS were compared with that of CECT.Results:The majority of RCC showed moderate enhancement in cortical phase, slight enhancement in parenchymal, delayed phase,only a small part showed slight enhancement in three phases. Correct diagnoses were obtained in 42 malignant and 7 benign masses by CEUS, while 38 malignant and 6 benign masses by CECT. There were only 4 malignant and 3 benign cases were misdiagnosed by CEUS while 5 malignant and 6 benign masses by CECT. The diagnostic performance of CEUS and CECT in characterrization of renal tumors were as follows: sensitivity 91.3%/88.4%, positive predictive value 91.3%/88.4%, diagnostic accuracy 87.5%/81.1%.Conclusions:CEUS can display the blood supply feature of renal neoplasms sensitively as CECT and play a complementary role in the diagnosis of renal cell carcinoma.