超声造影鉴别诊断肾脏占位性病变的价值

目的:探讨超声造影鉴别诊断肾脏占位性病变的意义。材料和方法:对29例肾脏占位性病变进行超声造影检查。观察并分析良、恶性病变的超声造影表现及灌注特征。结果:肾脏恶性病灶造影剂退出时间多早于肾实质(15/16);其中,肾透明细胞癌在造影晚期多表现为病灶周边环状强回声带(8/11)。肾脏良性病灶中,错构瘤6例造影剂退出与肾实质相似,5例晚于肾实质,与肾脏恶性病灶存在显著性差异(P<0.05);1例肾嗜酸细胞瘤及1例中胚叶肾瘤造影开始减退时间早于肾实质,造影晚期亦可见病灶周边环状强回声带,难以与肾恶性病灶鉴别。结论:超声造影能够实时观察肾脏占位性病变的血流灌注情况,对肾占位性病变的诊断及鉴别诊断具有一定的临床意义。

The Value of Contrast-enhanced Ultrasound in the Differential Diagnosis of Renal Lesions

Purpose:Contrast enhanced ultrasound(CEU) was known of additional diagnostic value.The aim of the current study was to evaluate the significance of contrast-enhanced ultrasound in the differential diagnosis of local renal lesions.Materials and Methods:29 cases of local renal lesions were examined by contrast-enhanced ultrasound.The characteristics of local lesions in CEU were observed.Results:Most of the malignant renal lesions were rich in blood supply with earlier wash-out of contrast agent than the renal parenchyma.Most renal clear cell carcinoma(8/11) showed a strong echo ring around the lesions in the late phase of CEU.The contrast agent washed out from hamartomas at the same speed as(6/11) or later than(5/11) renal parenchyma.One renal oncocytoma and one mesoblast adenoma also showed strong echo ring in the late phase of CEU.Conclusion:The kinetics of blood supply to renal lesions can be observed with contrast-enhanced ultrasound,which had important clinical significance in the differential diagnosis of renal lesions.