CEUS诊断肾脏占位性病变

目的 探讨CEUS在肾脏占位性病变中的应用价值。方法 对67例肾脏占位性病变患者术前行常规超声及CEUS检查，观察造影增强特征，并对其中40例肾透明细胞癌（CCRCC）和14例肾血管平滑肌脂肪瘤（AML）造影增强特征进行比较，并分析时间-强度曲线定量参数，包括峰值强度（IMAX）、上升时间（RT）、达峰时间（TTP）及平均渡越时间（mTT）。结果 CCRCC和AML的CEUS增强模式、增强强度、增强均匀度和假包膜征差异均有统计学意义（P均< 0.01）。CCRCC的IMAX高于AML，RT和mTT均早于AML （P < 0.05）。CEUS定性诊断恶性肾脏占位性病变的敏感度91.49%（43/47），特异度75.00%（15/20），准确率86.57%（58/67）。结论 CEUS结合造影定量分析软件有助于诊断和鉴别CCRCC与AML。

CEUS in diagnosis of renal occupying lesions

Objective To explore the application value of CEUS in diagnosis of renal occupying lesions. Methods Totally 67 patients with renal occupying lesions underwent conventional ultrasound and CEUS before surgical operation. CEUS enhancement characteristics were observed and compared between 40 patients with clear cell renal cell carcinoma (CCRCC) and 14 patients with angiomyolipoma (AML). Meanwhile the time-intensity curves were analyzed, including peak intensity (IMAX), rise time (RT), time-to-peak time (TTP) and mean transit time (mTT). Results There were significant differences in enhancement patterns, degrees, homogeneity of enhancement and pseudocapsule sign between CCRCC and AML (all P < 0.01). Compared with AML, IMAX of CCRCC was higher, RT and mTT were both earlier (P < 0.05). The sensitivity, specificity and accuracy of CEUS in diagnosis of malignant renal occupying lesions was 91.49% (43/47), 75.00% (15/20) and 86.57% (58/67), respectively. Conclusion CEUS combined with quantitative analysis software is helpful to diagnosis and identification of CCRCC and AML.