Minimal Fat Renal Angiomyolipoma: The Initial Study with Contrast-Enhanced Ultrasonography

We visualized minimal fat renal angiomyolipomas (AMLs) by contrast-enhanced ultrasonography (CEUS). Conventional ultrasound and CEUS images were retrospectively analyzed for solid minimal fat renal AML cases (n = 18) and solid renal cell carcinoma (RCC) cases (n = 105). We compared size, echogenicity and color flow signals with conventional ultrasound, and enhancement patterns with CEUS, in AMLs vs. RCCs. No significant differences in echogenicity and color flow signal existed between AMLs and RCCs using conventional ultrasound. With CEUS, slow centripetal enhancement in the cortical phase (83.3% of AMLs vs. 1.9% of RCCs) and homogeneous peak enhancement (100.0% of AMLs vs. 34.3% of RCCs) were valuable traits for differentiating these tumor types. These two CEUS-determined traits, combined, were differentiating criteria for minimal fat renal AMLs and RCCs; positive and negative predictive values were 100.0% and 97.2%, respectively. Slow centripetal enhancement in the cortical phase and homogeneous enhancement at peak are main features of CEUS-confirmed solid minimal fat renal AML.     

超声造影环状高增强征象诊断肾癌的特异性分析

目的 探讨超声造影环状高增强(PHR)征象对于肾常见肿瘤定性诊断的价值.方法 回顾性分析207例肾常见肿瘤(136个肾细胞癌,84个肾错构瘤)患者的超声造影图像,比较PHR在肾癌与肾错构瘤组间以及肾癌不同亚型组间检出率的差异.结果 肾癌组中,PHR的检出率为36.76％(50/136),肾错构瘤组未检出PHR;采用PHR诊断肾癌,其敏感性、特异性、准确性、阳性预测值、阴性预测值、假阳性率及假阴性率分别为36.76％(50/136)、100％(84/84)、60.91％(134/220)、100％(50/50)、49.41％(84/170)、0(0/50)、50.59％(86/170).PHR在肾透明细胞癌、乳头状肾癌、肾嫌色细胞癌及肾集合管癌四种肾癌亚型间检出率分别为31.03％(36/116)、81.82％(9/11)、62.50％(5/8)、0(0/1).结论 超声造影检出的PHR征象可作为诊断肾癌的特异性指标,且对于鉴别肾肿瘤的良恶性及肾癌病理亚型有一定的参考价值.     

The Nodular Form of Hepatic Tuberculosis

Objective. The purposes of this study were to describe the ultrasonographic findings in hepatic tuberculosis (TB) after administration of a second‐generation sulfur hexafluoride–filled microbubble contrast agent and to correlate these findings with pathologic characteristics. Methods. Twenty‐four hepatic TB lesions in 15 patients were studied with conventional ultrasonography (CUS) and contrast‐enhanced ultrasonography (CEUS). Pathologic characteristics of the lesions were evaluated and were then correlated with enhancement patterns. Results. The appearance of hepatic TB on CUS was variable and nonspecific with respect to the shape, echogenicity, and boundary of the lesions. The diameters of the lesions obtained from CEUS were statistically larger than those from CUS, with largest diameters ± SD of 4.2 ± 1.8 and 3.1 ± 1.9 cm, respectively. During the arterial phase, 13 of 24 lesions (54.2%) showed a rapidly and markedly enhanced rim with a hypoenhanced or nonenhanced center; 9 of 24 lesions (37.5%) showed transient enhancement of the whole lesion with inconsistent intensities. During the portal phase, most lesions showed distinct wash‐out of the contrast agent and maintained a hypoechoic appearance. Pathologic studies confirmed that the different appearances of hepatic TB on CEUS were related to the different pathologic stages of the lesions. Conclusions. Findings of hepatic TB on CEUS may be helpful in differentiating the diagnosis from other hepatic focal lesions. Correlation with pathologic findings would enrich the understanding of CEUS findings in hepatic TB.     

超声造影诊断肾脏小肿瘤

目的 探讨CEUS诊断肾脏小肿瘤的价值。方法 回顾性分析49例肾脏小肿瘤患者的常规超声与CEUS表现,其中38例为小肾癌(SRCC),11例为肾血管平滑肌脂肪瘤(RAML),主要观察肿块回声、增强模式、增强程度,与常规超声进行比较,评估CEUS鉴别诊断SRCC与RAML的效能。结果 SRCC与RAML的CEUS增强模式比较,二者弥漫不均匀增强[78.94%(30/38)vs 27.27%(3/11),P=0.003)]、延迟相快退[73.68%(28/38)vs 18.18%(2/11),P=0.001)]、病灶周边环状强化[57.89%(22/38)vs 9.09%(1/11),P=0.006)]3个特征检出率的差异均有统计学意义。采用CEUS诊断SRCC的敏感度、特异度、阳性预测值、阴性预测值和准确率分别为86.84%(33/38),63.63%(7/11),89.18%(33/37),58.33%(7/12)和81.63%(40/49)。结论 CEUS特征可用以诊断肾脏小肿瘤,且对SRCC和RAML的鉴别诊断具有较高价值。     

Focal Hypoechoic Tumors of Fatty Liver

Objective. The purpose of this study was to investigate the characteristics of focal hypoechoic tumors of fatty liver using conventional ultrasonography and contrast‐enhanced ultrasonography (CEUS). Methods. Sixty‐four hypoechoic tumors of fatty liver in 52 patients were examined by both conventional ultrasonography and CEUS. Contrast pulse sequencing and a sulfur hexafluoride contrast agent were used for CEUS. The enhancement patterns were evaluated in real time. Results . Hypoechoic tumors of fatty liver showed posterior echo enhancement, including 71.4% (25 of 35) of hemangiomas, 73.3% (11 of 15) of metastases, and 50.0% (3 of 6) of hepatocellular carcinomas (HCCs) on conventional ultrasonography. During the early arterial phase, 62.5% (5 of 8) of focal nodular hyperplasia lesions showed a central spoked wheel enhancement pattern, whereas the remaining 37.5% (3 of 8) showed eccentric spoked wheel enhancement. During the arterial phase, 97.1% (34 of 35) of hemangiomas showed peripheral enhancement and centripetal fill‐in, including ringlike peripheral enhancement (12 of 35), small nodular peripheral enhancement (19 of 35), and massive irregular peripheral enhancement (3 of 35). In total, 76.5% (26 of 34) of hemangiomas were completely filled in. All HCCs showed complete enhancement from 9 to 24 seconds during the arterial phase and began to wash out from 21 to 114 seconds. During the arterial phase, 40.0% (6 of 15) of metastases showed ringlike enhancement; 26.7% (4 of 15) showed slight hyperenhancement; 13.3% (2 of 15) showed hyperenhancement quickly; and the remaining 20.0% (3 of 15) showed heterogeneous hyperenhancement. All metastatic tumors began to wash out from 25 to 40 seconds. In total, 92.2% (59 of 64) of focal hypoechoic tumors of fatty liver were diagnosed as the correct pathologic type with CEUS. Conclusions. With CEUS, characterization of hypoechoic tumors of fatty liver is greatly improved.     

肾细胞癌常规超声及超声造影特征

目的 观察肾细胞癌（RCC）及其常见病理亚型的常规超声及超声造影（CEUS）特征。方法 纳入94例RCC（恶性组）及34例肾脏良性病变患者（良性组）,将恶性组分为肾透明细胞癌（ccRCC）亚组（n=74）和肾乳头状细胞癌（pRCC）及肾嫌色细胞癌（cRCC）亚组（n=16）;比较良、恶性组及恶性组2亚组病灶常规超声及CEUS特征。结果 恶性组主要表现为低回声（63/94,67.02%）、快进（84/94,89.36%）、快退（58/94,61.70%）及高增强（68/94,72.34%）,良性组主要表现为高回声（20/34,58.82%）、快进（22/34,64.71%）、慢退（16/34,47.06%）及高增强（15/34,44.12%）;组间病灶回声、CEUS增强方式、消退方式及增强强度差异均有统计学意义（P均<0.05）。恶性组内2亚组病灶增强程度差异具有统计学意义（P<0.05）,ccRCC主要表现为高增强（61/74,82.43%）,pRCC及cRCC主要表现为低增强（10/16,62.50%）。结论 RCC,尤其ccRCC超声多表现为低回声、快进、快退及高增强;常规超声及CEUS对术前诊断RCC有一定价值。     

Diagnostic efficacy of contrast-enhanced ultrasonography in solid renal parenchymal lesions with maximum diameters of 5 cm.

OBJECTIVE: The purpose of this study was to evaluate the diagnostic efficacy of contrast-enhanced ultrasonography (CEUS) using a sulfur hexafluoride contrast agent and the cadence contrast pulse sequencing mode in differentiating solid renal parenchymal lesions (SRPLs) with a maximum diameter of 5 cm. METHODS: Seventy-one patients with 72 SRPLs with a maximum diameter of 5 cm underwent conventional ultrasonographic and CEUS examinations in our department. The final diagnoses were 44 renal cell carcinomas (RCCs; confirmed by pathologic examination), 24 renal angiomyolipomas (4 by pathologic examination and 20 by computed tomography, magnetic resonance imaging, and follow-up studies), 1 oncocytoma (by pathologic examination), 2 hypertrophied columns of Bertin, and 1 renal abscess (both by computed tomography, magnetic resonance imaging, and follow-up studies). Three observers who were blinded to other results and the final diagnoses reviewed the conventional ultrasonographic and CEUS images. RESULTS: Hyperenhancement in the late phase (30-90 seconds after agent injection) was the most important finding for predicting SRPLs with a maximum diameter of 5 cm to be RCCs. With this criterion, the specificity and sensitivity for diagnosing solid RCCs (相似文献   

Value of Contrast‐Enhanced Ultrasonography in Assessing the Vascularity of Liver Metastases

Objective. The purpose of this study was to compare the capability of contrast‐enhanced ultrasonog‐raphy (CEUS) and contrast‐enhanced computed tomography (CECT) in evaluating the vascularity of liver metastases. Methods. Both CEUS and CECT examinations were performed on 70 patients with liver metastases, which were from colon carcinoma in 31, rectal carcinoma in 17, pancreatic carcinoma in 5, and others in 17. In patients with multiple lesions, the most easily observed lesion was selected as the target lesion for evaluation of vascularity. Results. Peak enhancement of the target lesion during the arterial phase was characterized as hyperenhancement, isoenhancement, hypo‐enhancement, and nonenhancement in 61 (87.1%), 6 (8.6%), 3 (4.3%), and 0 (0%) patients on CEUS, respectively, and in 52 (74.3%), 8 (11.4%), 8 (11.4%), and 2 (2.9%) on CECT. Contrast‐enhanced ultrasonography showed more lesions with hyperenhancement than CECT (P < .01). The enhancement pattern during the arterial phase was homogeneous, inhomogeneous, and rimlike in 30 (42.9%), 16 (22.9%), and 24 (34.2%) patients on CEUS and in 13 (18.6%), 8 (11.4%), and 49 (70%) on CECT. Contrast‐enhanced ultrasonography revealed more lesions with homogeneous enhancement than CECT (P < .01). Contrast‐enhanced ultrasonography showed dysmorphic vessels in 33 patients (47.1%) during the arterial phase, whereas CECT showed dysmorphic vessels in 27 (38.6%; P < .01). Contrast‐enhanced ultrasonography showed hypervascular lesions in 58.6% of patients, whereas CECT showed hypervascular lesions in 12.9% (P < .01). Conclusions. Contrast‐enhanced ultrasonography was superior to CECT in assessing the vascularity of liver metastases.     

Contrast‐Enhanced Breast Ultrasonography

Objective. The purpose of this study was to identify histopathologic correlates for the varied appearances of breast masses on contrast‐enhanced ultrasonography (CEUS). Methods. Contrast‐enhanced ultrasonography was performed in 104 patients (age range, 19–86 years) after administration of a sulfur hexafluoride microbubble contrast agent, and enhancement patterns were classified as no enhancement, peripheral enhancement, homogeneous enhancement, regional enhancement, and heterogeneous enhancement. All patients' histologic slides were reviewed and correlated with CEUS findings. Results. In malignant masses, heterogeneous enhancement corresponded to tumor cell cords or clusters in a variable amount of desmoplastic stroma. Homogeneous enhancement corresponded to hypercellularity in the whole mass, or ductal carcinoma in situ (DCIS) was predominant. Regional enhancement corresponded to a DCIS component. Peripheral enhancement corresponded to a DCIS component, hypercellularity or adenosis at the periphery, and low‐degree cellularity, degeneration, fibrosis, or necrosis in the center. No enhancement was present in 1 case of low‐grade DCIS. In benign masses, heterogeneous enhancement corresponded to loose cell proliferation in a more sclerotic stroma. Homogeneous enhancement corresponded to diffuse hypercellularity, an inflammatory cell infiltrate, or intraductal papilloma. Regional enhancement corresponded to focal hypercellularity or intraductal papilloma within a dilated duct. No enhancement corresponded to desmoplastic stroma. Peripheral enhancement was shown in 1 case of granulomatous mastitis with an inflammatory infiltrate at the periphery and necrosis in the center. Conclusions. Breast mass CEUS findings correlated with histologic features.     

Clinical Application of Contrast‐Enhanced Ultrasonography in Diagnosis of Superficial Lymphadenopathy

Objective. The purpose of this study was to evaluate the value of contrast‐enhanced ultrasonography (CEUS) in differential diagnosis of superficial lymphadenopathy. Methods. Ninety‐four superficial enlarged lymph nodes in 94 patients were studied by conventional ultrasonography (gray scale and color Doppler) and CEUS. Contrast‐enhanced sonograms were analyzed using contrast‐specific quantification software. All of the results were compared with pathologic diagnoses. Results. Of the 94 lymph nodes examined, 44 were benign and 50 were malignant (33 metastases and 17 lymphomas). The sensitivity, specificity, and accuracy of conventional ultrasonography in differential diagnosis between benign and malignant nodes were 51%, 47%, and 55%, respectively. Contrast‐enhanced ultrasonography showed intense homogeneous enhancement in 39 of 44 benign lymph nodes, inhomogeneous enhancement in 32 of 33 metastases, and intense homogeneous enhancement and absence of perfusion in 9 of 17 and 6 of 17 lymphomas, respectively. The sensitivity specificity, and accuracy of CEUS were 84%, 79%, and 80%. After time‐intensity curve gamma variates were calculated, the area under the curve of the benign lymph nodes was greater than those of the metastatic lymph nodes and lymphomas (P < .01). Conclusions. These results indicate that the use of CEUS and contrast‐specific software has a higher degree of diagnostic accuracy than conventional ultrasonography for evaluations of superficial lymphadenopathy. The contrast enhancement patterns and time‐intensity curves provide valuable diagnostic information for differential diagnosis of benign and malignant lymph nodes.     

Quantification of Enhancement of Renal Parenchymal Masses with Contrast-Enhanced Ultrasound

The purpose of this study was to investigate the value of quantitative assessment of enhancement in diagnosing renal cell carcinoma (RCC) with contrast-enhanced ultrasound (CEUS). A total of 73 solid renal parenchymal masses underwent both conventional ultrasound and CEUS. We compared the difference in maximum diameters on conventional ultrasound and CEUS between the benign and malignant groups. Enhancement features derived from a time-intensity curve were also analyzed. The diameters of renal cancer were found to be larger on CEUS than on conventional ultrasound (p < 0.05). When cutoff values of 4.74 s for washout time and 8.52% for enhancement intensity at 60 s for diagnosing RCCs were applied, the sensitivity, specificity and area under the receiver operating characteristic curve were 67.3%, 95.2%, 86.5% and 65.4%, 81.0%, 68.4%, respectively. The sensitivity and specificity for these two enhancement characteristics combined as a criterion for differentiating RCCs from benign lesions were 44.0% and 99.1%, respectively. Early washout in the area of maximal intensity in the interior of the lesion and prolonged washout in the whole area of the lesion are specific CEUS manifestations suggestive of RCC.     

Sonazoid‐Enhanced Ultrasonography for Evaluation of the Enhancement Patterns of Focal Liver Tumors in the Late Phase by Intermittent Imaging With a High Mechanical Index

Objective. The purpose of this study was to evaluate the enhancement patterns of focal liver tumors in the late phase of Sonazoid‐enhanced ultrasonography by intermittent imaging with a high mechanical index (MI). Methods. A total of 142 patients with 208 lesions, including 109 hepatocellular carcinomas (HCCs), 61 metastases, 30 hemangiomas, and 8 focal nodular hyperplasias (FNHs), were enrolled in this prospective study. Contrast‐enhanced ultrasonography with intermittent scanning at 2 frames per second (MI, 0.7–1.2) was conducted in the late phase (>5 minutes after bolus intravenous injection of the perflubutane‐based contrast agent Sonazoid; Daiichi Sankyo, Tokyo, Japan). Two blinded readers classified the enhancement patterns of the lesions. The sensitivity, specificity, and positive predictive value (PPV) of the dominant enhancement patterns and inter‐reader agreement were assessed. Results. A combination of diffuse enhancement with intratumoral vessels and intratumoral vessels alone yielded sensitivity of 85% (average of both readers), specificity of 88%, and a PPV of 88% for HCC. For metastasis, a combination of peripheral ringlike enhancement with peritumoral vessels and peripheral ringlike enhancement with intratumoral vessels yielded sensitivity of 79%, specificity of 95%, and a PPV of 85%. For hemangiomas, a combination of peripheral nodular enhancement with peritumoral vessels and peripheral nodular enhancement without peritumoral vessels yielded sensitivity of 75%, specificity of 99%, and a PPV of 92%. Diffuse enhancement with spoked wheel arteries yielded sensitivity of 82%, specificity of 100%, and a PPV of 87% for FNHs. Good inter‐reader agreement was achieved. Conclusions. Sonazoid‐enhanced ultrasonography using intermittent imaging with a high MI can potentially be used for evaluating the enhancement patterns of focal liver tumors in the late phase.     

超声诊断巨大肾血管平滑肌脂肪瘤

目的 探讨巨大肾血管平滑肌脂肪瘤(最大径大于5 cm)的声像图特点. 方法 回顾性分析手术病理证实的17个巨大肾血管平滑肌脂肪瘤的超声表现,包括病变大小、边界、位置、内部回声及血流特点. 结果 采用超声检查,11个准确定位(其中9个正确诊断为RAML),5个定位不清,1个误诊为肾上腺占位;声像图表现为边界清晰的高回声、低回声、中等回声或高低回声相间的混合性回声.较大的高回声、大多数混合性回声及所有低回声病灶内可探及程度不等的血流信号,其声像图表现类型与病灶内脂肪、平滑肌和血管的组成和分布密切相关. 结论 巨大肾血管平滑肌脂肪瘤具有特征性的声像图表现,超声结合其他影像学检查,对多数病灶可于术前明确诊断.     

Behavior of Hepatocellular Adenoma on Real‐time Low‐Mechanical Index Contrast‐Enhanced Ultrasonography With a Second‐Generation Contrast Agent

Objective. The purpose of this study was to describe the behavior of histologically proven hepatocellular adenoma (HCA) on low‐mechanical index (MI) contrast‐enhanced ultrasonography (CEUS). Methods. A review of the databases from 4 academic hospitals revealed 18 patients (15 female and 3 male; mean age, 40 years; range, 25–71 years) with 25 histologically proven HCA lesions who were studied with CEUS at a low MI (0.04–0.1). Results. Twenty‐four of 25 lesions (96%; 95% confidence interval [CI], 80.5%–99.3%) showed high‐intensity enhancement, scored as 3 on a scale of 0 to 3, whereas only 1 lesion (4%; 95% CI, 0.7%–19.5%) was scored as 2. The time of peak enhancement ranged between 10 and 19 seconds (average, 13 seconds). All but 1 of the 25 lesions (96%; 95% CI, 80.5%–99.3%) showed early homogeneous and centripetal enhancement during the hepatic arterial phase. No portal venous phase enhancement was observed in any lesion because all showed rapid wash‐out (100%; 95% CI, 86.7%–100%). Twenty lesions (80%; 95% CI, 60.9%–91.1%) were found to be isoechoic to slightly hypoechoic during the portal phase, and 19 (76%; 95% CI, 56.6%–88.5%) were isoechoic to mildly hypoechoic, whereas 7 (24%; 95% CI, 11.5%–43.4%) were hypoechoic during the late phase. Conclusions. Contrast‐enhanced ultrasonography is an effective technique for identifying the microvascular and macrovascular characteristics of HCA. Typically, HCA shows early (10–19 seconds) and centripetal enhancement during the arterial phase and isoechogenicity or mild hypoechogenicity during the portal phase, remaining slightly hypoechoic or isoechoic during the late phase in most cases.     

对比超声造影与CT诊断肾细胞癌

目的 探讨CEUS与CT诊断肾细胞癌(RCC)的价值。方法 对可疑肾脏占位性病变患者92例行CEUS和CT增强扫描检查,并与术后病理结果比较,计算CEUS及CT增强扫描诊断RCC的敏感度、特异度及准确率。结果 CEUS和CT增强扫描在RCC增强程度、增强减退情况及假包膜征方面差异有统计学意义(P<0.05)。CEUS及CT增强扫描诊断RCC的敏感度、特异度和准确率分别为95.89%(70/73)、57.14%(8/14)、89.66%(78/87)和78.08%(57/73)、50.00%(7/14)、73.56%(64/87)。结论 CEUS显示RCC低速血流、微循环血供及诊断敏感度和准确率均优于CT增强扫描。     

Contrast‐Enhanced Ultrasonography in Patients With Glycogen Storage Disease Type Ia and Adenomas

Objective. The purpose of this series was to evaluate the value of contrast‐enhanced ultrasonography (CEUS) in the characterization of focal liver lesions (FLLs) in patients with glycogen storage diseases (GSDs). Methods. Contrast‐enhanced ultrasonographic data obtained for characterization of 8 FLLs (size, 0.9–10.2 cm) in 2 patients with GSD type Ia (GSD‐Ia) and lesion growth or recurrent abdominal pain were reviewed and compared with computed tomographic (CT) and magnetic resonance imaging (MRI) data. After total and left hepatectomy, pathologic examination confirmed benign adenomas in 6 of the evaluated lesions. Follow‐up confirmed benignity in the 2 remaining lesions. Results. In all FLLs, CEUS showed marked hypervascularity in the early arterial phase. Centripetal filling was shown in only 1 lesion, and diffuse enhancement without any clear direction was shown in all other lesions. During the portal and late phases, 6 of the 8 lesions showed sustained enhancement, including 2 lesions that appeared heterogeneous during all phases of CT and MRI. In an aspect of 1 of these 6 large adenomas, late wash‐out could be explained by sinusoid compression. The other 2 adenomas showed moderate wash‐out but remained homogeneous. Conclusions. Focal liver lesions found in patients with GSD‐Ia have similar patterns on CEUS compared with incidental adenomas. Global or partial hypoenhancement observed in the late phase did not indicate a transition to hepatocellular carcinoma but may have been related to ischemia.     

甲状腺单发结节的超声造影分析

目的分析各种病理类型甲状腺单发结节超声造影的图像特点,研究超声造影是否可以改善对各种甲状腺单发结节的鉴别诊断率。方法回顾性分析经手术病理证实的30例甲状腺单发结节超声造影的图像特点。观察结节内造影剂灌注的过程,通过时间-强度曲线进行分析,比较结节内部与结节相邻的甲状腺实质内造影剂到达时间（AT）,达峰时间（TTP）,增强强度△A（PI-BI）等参数的差别。这些数据和手术后病理组织学结果进行对照分析。结果5例甲状腺癌造影后表现为结节先于相邻甲状腺实质开始增强及廓清,与相邻的甲状腺实质相比较呈高增强。10例滤泡性腺瘤中有7例造影后表现为结节晚于相邻甲状腺实质开始增强及廓清,与相邻的甲状腺实质相比较呈低增强。15例结节性甲状腺肿中8例造影后表现为结节早于相邻甲状腺实质开始增强及廓清,14例与相邻的甲状腺实质相比较呈高增强或等增强。结论此研究表明各种病理类型甲状腺结节造影剂灌注的特点仍有一定的重叠性,但超声造影技术可能为鉴别甲状腺良恶性肿瘤提供更多有效的,补充性的信息和定量分析的方法。     

超声造影在肾细胞癌亚型鉴别诊断中的价值

目的探讨超声造影在肾细胞癌亚型鉴别诊断中的应用价值。方法 2004年6月至2010年2月常规超声和超声造影检查343例肾细胞癌患者346个病灶,均经手术及病理证实。常规超声观察肿瘤的大小、回声、边界、有无彩色血流信号、血管位置等。超声造影观察病灶的增强方式和增强时相,包括起始时间、达峰时间、消退时间及病灶的增强表现。结果经手术和病理证实304个病灶为透明细胞肾癌,23个为乳头状肾癌,19个为嫌色细胞肾癌。不同亚型肾细胞癌常规超声表现没有明显差异。不同亚型肾细胞癌的增强时相差异无统计学意义(P>0.05)。透明细胞肾癌表现为皮质期同步增强、达峰值时呈高回声和等回声、实质期快速减退为主,而乳头状肾癌和嫌色细胞肾癌皮质期表现为同步增强和缓慢增强、达峰值时呈低回声和等回声、实质期以快速减退为主。乳头状肾癌与透明细胞肾癌比较,两组病灶皮质期、达峰值回声和实质期的表现差异有统计学意义(P均=0.000);嫌色细胞肾癌与透明细胞肾癌比较,两组病灶皮质期、达峰值回声和实质期的表现差异有统计学意义(P=0.000,P=0.000,P=0.001)。结论超声造影有助于肾细胞癌亚型的鉴别。     

超声造影与增强CT鉴别诊断良恶性甲状腺结节

目的 对比超声造影（CEUS）与增强CT鉴别诊断良恶性甲状腺结节的价值。方法 纳入179例甲状腺结节患者、共229个结节,根据结节性质分为良性组（n=83）和恶性组（n=146）;观察结节CEUS和增强CT特征,以病理结果为金标准,对比2种影像学方法鉴别诊断良恶性甲状腺结节的效能。结果 良、恶性组甲状腺结节CEUS增强强度、增强模式及有无环绕增强差异均有统计学意义（P均<0.05）;增强CT强化特点、边缘情况、甲状腺边缘有无中断及钙化性质差异亦均有统计学意义（P均<0.05）。CEUS诊断甲状腺良恶性结节的敏感度、特异度及准确率分别为89.73%、78.31%及85.59%;增强CT诊断分别为78.08%、71.08%及75.55%。结论 CEUS和增强CT鉴别甲状腺良恶性结节均有一定价值;CEUS的诊断效能总体优于增强CT。     

超声造影在良性囊性肾占位中的应用

目的 分析超声造影在肾脏良性囊性占位中的表现,探讨其应用价值.方法 对24例24个经手术病理证实为肾脏良性囊性占位患者的常规超声及超声造影声像图进行回顾性分析.常规超声观察囊性占位大小、回声、边界、有无彩色血流信号.超声造影观察病灶囊壁、分隔及实质成分等内部结构的增强表现.结果 本组24个囊性肾占位经手术和病理证实单纯性囊肿11个,复杂性囊肿5个(其中4个伴出血或感染),肾实质和肾盂炎症5个,肾脏血肿2个和肾盏憩室1个.24个囊性病变最大直径范围2.1～19.4 cm,其中<3.0 cm 7个.常规超声显示囊性肿块8个,囊实性肿块16个,其中内见分隔12个,钙化6个,囊壁增厚或实质成分4个.5个病灶囊壁或分隔上发现彩色血流信号,19个未显示彩色血流信号.超声造影后15例见病灶增强,其中7个表现为少分隔规则增强,5个囊壁增强,3个蜂窝状增强,另9例未见增强.结论 囊性肾占位无增强、囊壁增强或少分隔规则增强应考虑良性病变,超声造影对诊断有较大的帮助.