肾嗜酸细胞瘤超声表现1例

患者男 ,39岁。因“左腰区间歇性疼痛 2 0d ,加重 5d”入院。查体 :血压 1 6/ 1 2kPa ,左肾区轻叩痛。彩色多普勒超声显示 :右肾无异常 ,左肾上极测及大小约 4 .5cm× 4 .0cm× 4 .9cm实性低回声团块 ,向肾外突出 ,边界清晰 ,形态尚规则 ,内部回声不均匀 ,团块内似可显示不规则低回声区 ,并可测及一带状稍高回声区 (图 1 )。超声诊断 :左肾实性占位 ,左肾嗜酸细胞瘤可能。CT扫描 :于左肾中上部偏外肾实质内见大小约 4 .3cm× 4 .3cm× 3 .0cm低密度灶 ,平均CT值 2 0Hu,局部向肾外膨隆 ,增强扫描病灶有强化 ,其内可见不规则低密度不强化区…     

肾嗜酸细胞瘤超声表现

目的 探讨肾嗜酸细胞瘤(RO)的声像图特征.方法 回顾性分析手术病理证实的12例RO患者的超声表现,包括病变大小、边界、形态、回声水平及血流特点.结果 12例RO患者中,超声准确定位所有病灶,其中3例误诊为肾癌,9例未能做出定性诊断.超声发现8.33%RO有中央星状瘢痕,66.67%回声均匀、75.00%边界清晰、91.67%形态规则和58.33%为等回声,66.67%肿瘤周边见环绕血流,50.00%内部多血供,且呈轮辐状分布,41.67%少血供,8.33%无血供.结论 超声对RO定性诊断较困难,但对内部回声均匀、界清、血流轮辐状分布、尤其有中央星状瘢痕的肾实性肿物,应考虑RO可能.     

肾嗜酸细胞瘤超声表现一例

患者男,70岁,左腰部胀痛2年余,无发热及肉眼血尿。查体:左肾区轻度叩痛,其余阴性。实验室检查示:血常规、尿常规+沉渣、肾功能等均未见异常。腹部超声检查示:左肾体积增大,外形异常,于中下极探及孤立实性中等偏高回声团块,大小为7.5cm×6.9cm×6.5cm,边界清楚,类圆形,似有包膜,局部外凸,内回声不均,中心部可见星形低回声区(图1);彩色多普勒血流成像示:团块周边见血流信号绕行,中心部低回声区未见明显血流信号,其余内部可见短条     

肾嗜酸细胞瘤的超声表现分析

目的:探讨肾嗜酸细胞瘤(renal oncocytoma,RO)的超声表现。方法:分析经手术后病理学检查证实的22例RO患者的超声表现,归纳其声像图特征,包括肿瘤位置、大小、形态、边界、内部回声、后方回声、血供特点及超声造影表现等。结果:22例患者RO均位于单侧肾脏。17例肿块内部呈等回声或(稍)高回声,3例肿块内部见放射状低回声;13例肿块边界清或尚清;7例肿块后方回声增强,其中6例为高回声肿块;17例肿块内部见丰富或较丰富彩色血流。6例肿块行超声造影检查:皮质期均与肾皮质同步增强,达峰值时2例呈稍低回声,4例呈等回声,其中1例见放射状始终不增强区;实质期3例减退快于肾皮质,1例同步减退,2例缓慢减退,2例肿瘤实质期见假包膜回声。结论:RO多为界清的等回声或稍高回声,后方回声可增强的血供较丰富肿块,内部可见中心放射状瘢痕。超声造影多为同步均匀增强快速减退为主,达峰值呈等或低回声,实质期可出现假包膜,内部可见放射状始终不增强区。     

肾嗜酸细胞瘤超声诊断36例分析

对我院1993-10～2006-05肾嗜酸细胞瘤超声诊断36例分析如下。1临床资料1.1一般资料本组男22例,女14例,年龄32～77岁。均经过手术获得病理学诊断。1.2仪器与方法采用Acuson-512彩色多普勒超声诊断仪,3.5 MHz探头,选用腹部软件系统。采用直接探查法,进行多切     

5例肾嗜酸性细胞瘤的超声表现

肾嗜酸性细胞瘤(renal oncocytoma)术前影像误诊率极高[1].笔者分析了北京大学第三医院2000年1月至2009年4月经手术病理确诊的5例肾嗜酸性细胞瘤的超声表现与病理所见.患者的临床资料见表1,所有患者尿检查均无异常,术前超声和CT检查均提示肾癌.     

5例肾嗜酸性细胞瘤的超声表现

肾嗜酸性细胞瘤(renal oncocytoma)术前影像误诊率极高[1].笔者分析了北京大学第三医院2000年1月至2009年4月经手术病理确诊的5例肾嗜酸性细胞瘤的超声表现与病理所见.患者的临床资料见表1,所有患者尿检查均无异常,术前超声和CT检查均提示肾癌.     

肾嗜酸细胞瘤1例超声误诊分析及文献复习

目的:探讨肾嗜酸细胞瘤的超声表现并分析误诊原因和防范措施。方法:回顾性分析1例误诊为肾细胞癌的嗜酸细胞瘤的临床资料,并复习相关文献。结果:该患者因体检于复旦大学附属闵行医院就诊,行常规超声检查发现右肾稍高回声病灶(性质待查)。近1个月后于上级医院行超声造影检查,发现其影像学表现与肾脏恶性肿瘤相似,误诊为肾细胞癌。后于复旦大学附属肿瘤医院行手术治疗,术后病理学诊断为肾嗜酸细胞瘤。半年后随访,病灶未见复发。结论:肾嗜酸细胞瘤临床较少见,影像学表现类似于恶性肿瘤而易误诊,临床医师应提高认识,拓展诊断思路,从而避免或减少误诊。     

肾嗜酸细胞腺瘤彩色多普勒超声表现1例

患者男,56岁.主因发现右侧腹部质硬肿物6个月入院.查体:右上腹可触及质硬的圆形肿物,表面不光滑,边界尚清楚,可移动.尿常规:未见异常.彩超检查:左肾未见异常.右肾中下部可见126.1 mm×115.8 mm×114.8 mm均匀的中等回声肿物,形态规整,包膜清楚.     

肾肉瘤样癌超声造影表现1例并文献回顾

肉瘤样肾细胞癌在肾细胞癌中极少见,术前准确判定肾癌类型对于确定手术切除的程度很有帮助,对肾肉瘤样癌手术切除需扩大手术范围,且由于其倾向于转移,术前还需对转移性病灶进行评估。所以增强超声医师对肾肉瘤样癌的认识对其治疗有重要意义。     

神经鞘瘤超声误诊1例

*通讯作者:苏畅? Tel:17702488827 ? Email:suchang0117@163.com     

肾癌的超声诊断分析

目的 探讨肾癌的超声表现,特别囊性肾癌的声像图特征,以提高超声对肾癌的诊断水平.方法 对37例经手术和病理证实的肾癌术前超声诊断资料进行回顾性分析.结果 肾癌的声像图表现为多样性,37例中以不均质中低回声病灶最多见,共22例,占59.5%(其仅4例回声较均匀);混合性回声病灶10例,占27.0%;囊性病灶5例,占13.5%(其中多房囊性3例,单房囊性2例).超声诊断符合率91.9%(34/37).其中1例误诊为错构瘤,1例误诊为囊肿伴出血,1例误诊为单纯性囊肿.结论 超声检查对肾癌有较高的诊断价值,但需加强对囊性肾癌的认识,以提高囊性肾癌的术前诊断正确率.     

A case of sigmoidouterine fistula detected by transvaginal ultrasonography

An 80-year-old woman, 2 G 2 P, with macrohematuria came to this institution for treatment. On pelvic examination, the uterus was palpated slightly large for her age, slight tenderness and resistance were noted at the uterine corpus, and the adnexa and parametrium were soft. The entire abdomen, including the Douglas pouch and pelvic bottom, were also soft. Examination a the speculum revealed swelling of the vulva and vagina and blood oozing from the entire vaginal wall. There was also a small amount of purulent discharge at the cervical canal. Transvaginal ultrasonography (TVUS) showed the uterine corpus to be small and found no adnexal or pelvic mass. However, the entire uterine cavity was hyperechoic, and these signals were passing through the myometrium near the fundus and ended in a cup-shaped configuration. These features were consistently confirmed on later repeated TVUS examinations. On further interview, the patient disclosed that the had had continual diarrhea and fecal discharges from the vagina for close to one month. The cytology of the smears from both the uterine cervix and cavity were negative, but purulent content was found in the endometrial biopsy specimen. Computed tomography and magnetic resonance imaging revealed no pathologic findings, but a colonic mass lesion adjacent to the uterus was observed although the fistula could not be identified. Innumerable diverticula in the colon and the outlines of barium spillage from the colon were demonstrated on barium enema examination. Colonic fiberscopic examination confirmed the intact colonic mucosa. Of the tumor markers, CA 19-9 and SCC values were normal, while CEA level was elevated (9.8 ng/ml). Surgery revealed a fistula that was perforated from the bottom of the sigmoid diverticulum through the uterine myometrium, and into the uterine cavity. The features of fistulas delineated by the continuous high-echoic signals on TVUS were identical with these pathological findings. The microbubbles of bowel gas in fecal discharges were deemed to be the cause of high echogenicity. These TVUS findings were repeatedly confirmed on later evaluations. A diagnosis of a sigmoidouterine fistula on TVUS should, therefore, be considered when there is fecal discharge. TVUS thus provided crucial and reliable findings of uterine fistula and should warrant use in managing colonic-uterine fistula. The postoperative course was uneventful. CEA concentration decreased to 3.4 ng/ml; cut-off value was 5 ng/ml.     

A case of splenosis: diagnosis with contrast-enhanced ultrasonography

We performed contrast-enhanced ultrasonography (CEUS) for a patient with known splenosis. One mass was clearly enhanced while another mass showed moderate enhancement. The right kidney showed similar enhancement and was a little confusing. We concluded that CEUS is useful for diagnosing this entity, although it has some limitations. CEUS could be a better diagnostic option than scintigraphic studies.     

超声误诊颌下腺神经鞘瘤一例

1908年,外国学者Verocay首次提出了“神经鞘瘤”,这是一种来自周围神经鞘膜施旺细胞的良性肿瘤,故也称之为施万细胞瘤。好发于交感、迷走神经。25%～45%发生在头颈部,其中颈部占10%～19%,以颞骨、侧颈部和副鼻窦区最为常见,舌部也比较常见。唾液腺神经鞘瘤临床上罕见,大多出现在腮腺,而发生在颌下腺的神经鞘瘤更是罕见,仅见极少个案报道。颌下腺神经鞘瘤很少有症状,术前诊断困难。     

彩色多普勒超声检查发现早期真性肾动脉瘤1例

患者男,34岁,空中机械师,体检超声发现右肾动脉瘤,无症状和阳性体征.B超示右肾门处有一囊性回声,范围约1.86 cm×1.13 cm,囊壁不光滑,回声略增强,囊腔内未探及血栓回声,动态追踪显示囊性区与右肾动脉相连续,肾动脉可见一宽约0.27 cm的开口.     

Usefulness of intraoperative contrast-enhanced ultrasonography in laparoscopic enucleation of small pancreatic metastases from renal cell carcinoma: A case report

Pancreatic metastasis from renal cell carcinoma (RCC) is relatively rare. Surgical resection of the lesion is recommended if no residual tumor remains. Although there is no clear standard for surgical procedures, enucleation can be considered for small lesions. Lesion identification is important for enucleation, and contrast-enhanced ultrasound which takes advantage of the characteristics of hypervascular lesions was useful in a 68-year-old woman who underwent a left nephrectomy for RCC 11 years ago that was pathologically diagnosed as clear cell carcinoma. Recent computed tomography checkup showed a hypervascular tumor of 6 mm in the uncinated process and 10 mm in the pancreatic tail. Endoscopic ultrasonography-guided fine-needle aspiration was performed for the tail lesion, a diagnosis of clear cell carcinoma was made, and laparoscopic enucleation of the pancreatic tumors was performed aided by intraoperative contrast-enhanced ultrasound. The postoperative course was uneventful, and no pancreatic fistula occurred.     

1例嗜酸性粒细胞胃肠炎病人的护理

嗜酸性粒细胞胃肠炎(eosinophilic gastroenteritis,EG)是很少见的疾病,其原因不明,以胃肠道组织中嗜酸性粒细胞异常浸润为特征的胃肠道疾病,临床表现无特异性,误诊率高.易反复发作,但有自限性,激素治疗有效.目前全世界仅报道300多例[1],我科2004年3月收治了1例嗜酸性粒细胞胃肠炎的病人,后又相继在我科住院治疗2次.现将对该病人的护理介绍如下.     

肝脏恶性间皮瘤一例超声造影表现

[Keyword] Livers; Mesothelioma; Ultrasonography