肾肿瘤的超声造影研究

目的探讨各种不同肾肿瘤的超声造影表现。方法124例肾肿瘤（平均直径3.4cm）,应用超声造影观察肿块回声增强时间和造影剂消退时间（皮质相与延迟相）,观察肿块的假包膜（与二维声像图对比）,所有患者均行手术和病理证实。结果透明细胞癌和乳头状癌98例,移行细胞癌5例,肾盂鳞癌6例,血管平滑肌脂肪瘤7例,肾盂上皮细胞癌1例,肾母细胞瘤5例,嗜酸细胞瘤2例（潜在恶性）。透明细胞癌98中超声造影有58例出现假包膜（58/98,73.3%）,而二维声像图显示假包膜31例（31/98,17%）;造影剂呈快进快退76例,快进慢退11例,慢进慢退7例,肿块局部回声增强4例。而血管平滑肌脂肪瘤回声增强程度明显低于肾细胞癌。结论超声造影有助于鉴别肾肿瘤,有助于显示出肾细胞癌的假包膜。

Contrast-enhanced ultrasound in the characteristics of renal tumors

Objective To investigate the characteristics of contrast-enhanced ultrasound(CEUS) in renal tumors.Methods One hundred and twenty four patients with renal tumors were prospectively studied with CEUS.When using SonoVue to examine the renal tumors,the time of tumors enhancement and wash-out of the contrast (arterial phase or cortex phase and delayed phase) were observed and pseudocapsule in renal cell carcinomas (compared to baseline sonography) were detected.All patients with renal tumors had proven by operation and histological findings.Results Ninety-eight solid renal cell carcinomas (RCCs),five transitional cell carcinomas of renal pelvis,six squamous cell carcinomas,seven angiomyolipomas(AMLs),one epidermoid carcinoma,five Whilms tumors and leukocyte cell tumors were analyzed.Fifty-eight RCCs showed pseudocapsule with CEUS compared to thirty-one at baseline sonography.Seventy-six RCCs revealed a high wash-in and wash-out with CEUS.Eleven RCCs showed a high wash-in and the delayed wash-out with CEUS.The delayed wash-in and wash-out were observed in seven RCCs.Four RCCs showed focal enhancement with CEUS.RCCs revealed a higher contrast enhancement than angiomyolipomas with CEUS.Conclusions CEUS may differentiate renal tumors and show clearly pseudocapsule in RCCs.