超声造影与增强CT对肾脏占位性病变良恶性鉴别诊断的效能比较

目的 分析超声造影、增强CT及联合检查对肾脏占位性病变的定性鉴别诊断效果。 方法 以2017年2月—2020年2月于宁海县第一医院医疗健康集团就诊的126例肾脏占位性病变患者为研究对象,分别进行超声造影检查和增强CT检查,统计超声造影、增强CT和联合检查对不同病理类型和病灶大小的肾脏占位性病灶良恶性鉴别诊断灵敏度、特异性和准确率,比较三种检查方法的诊断效能差异。 结果 对不同病理类型肾脏占位性病变,联合检查灵敏度(96.47%)和准确率(93.65%)均显著高于增强CT单独检查水平(78.82%和74.60%),均P<0.017,而超声造影与增强CT单独检查的灵敏度(88.24%vs. 84.92%)和准确率(84.92%vs. 74.60%)差异均无统计学意义(均P>0.017);对病灶直径≥3 cm肾脏占位病变,三种检查的灵敏度、特异性和准确率差异均无统计学意义(均P>0.017);对病灶直径<3 cm肾脏占位病变,联合检查的灵敏度(94.34%)和准确率(91.78%)均显著高于增强CT单独检查(67.92%和64.86%),均P<0.017,且超声造影检查的灵敏度和准确率(88.68%和85.14%)显著高于增强CT水平(67.92%和64.86%),均P<0.017。 结论 超声造影和增强CT对肾脏占位性病变均具有较高的定性诊断价值,超声造影对于小体积肾脏占位性病变定性诊断优于增强CT,两者联合诊断可提高诊断效能。 

Comparison of the effectiveness of differential diagnosis on renal space occupying lesions between and contrast-enhanced ultrasonography and contrast-enhanced CT

Objective To analyze the effect of contrast-enhanced ultrasonography, enhanced CT and combined examination in the qualitative differential diagnosis of renal space occupying lesions. Methods Total 126 cases of renal space occupying lesions whom were treated in Ninghai First Hospital Medicare and Health Group from February 2017 to February 2020 were studied. All patients were examined by contrast-enhanced ultrasonography and contrast-enhanced CT respectively. The sensitivity, specificity and accuracy of contrast-enhanced ultrasonography, contrast-enhanced CT and combined examination in the differential diagnosis of benign and malignant renal space occupying lesions with different pathological types and different lesions sizes were compared. Results In the differential diagnosis of different pathological types of renal space occupying lesions, the sensitivity(96.47%) and accuracy(93.65%) of combined examination were significantly higher than those of contrast-enhanced CT(78.82% and 74.60%)(all P<0.017), while there was no significant difference in sensitivity(88.24% vs. 84.92%) and accuracy(84.92% vs. 74.60%) between contrast-enhanced ultrasonography, enhanced CT alone(P>0.017). In the differential diagnosis of benign and malignant renal lesions with a diameter ≥ 3 cm, there was no significant difference in sensitivity, specificity and accuracy of the three examinations(all P>0.017). In the differential diagnosis of benign and malignant renal lesions with a diameter<3 cm, the sensitivity(94.34%) and accuracy(91.78%) of combined examination were significantly higher than those of contrast-enhanced CT alone(67.92% and 64.86%)(all P<0.017), and the sensitivity(88.68%) and accuracy and(85.14%) of contrast-enhanced ultrasound were significantly higher than those of contrast-enhanced CT(67.92% and 64.86%)(all P<0.017). Conclusion Contrast-enhanced ultrasound and contrast-enhanced CT have higher qualitative diagnostic value for renal space occupying lesions. Contrast-enhanced ultrasound is slightly better than contrast-enhanced CT in the qualitative diagnosis of small renal space occupying lesions. The combined diagnosis can improve the differential diagnosis efficiency of benign and malignant renal space occupying lesions.