实时超声造影对肾脏肿瘤诊断价值的应用研究

目的探讨实时超声造影技术在肾脏肿瘤诊断和鉴别诊断中的应用价值。方法对65例经常规二维及彩色多普勒超声检查诊断为肾肿瘤或可疑肾肿瘤的患者进行实时超声造影。观察造影剂在病灶内时相变化的规律及造影剂在肿瘤内分布的特点，并与病理结果进行对照。结果65例病灶中41例为恶性病灶，24例患者为良性病灶，二维及彩色多普勒超声诊断准确率80．0％（52／65），敏感性87．8％（36／41），特异性66．7％（16／24）；使用超声造影检查后准确率、敏感性和特异性均提高，分别为93．8％（61／65）、97．6％（40／41）、87．5％（21／24）。肾脏恶性肿瘤的造影模式主要为快进快退不均匀高增强，而肾血管平滑肌脂肪瘤多表现为慢进慢退低或等增强。结论超声造影技术为肾脏肿瘤的检出提供了更为丰富的信息，对肾脏肿瘤的诊断及鉴别诊断具有一定价值。

Study on diagnostic value of renal tumors by real-time contrast-enhanced ultrasonography

Objective To evaluate the application of real-time contrast-enhanced ultrasongraphy （CEUS） in the diagnosis and differential diagnosis of renal masses. Methods CEUS was performed in 65 cases of renal tumors which were detected by conventional color Doppler ultrasongraphy. The features of renal tumors on CEUS were analyzed and compared with those of pathology. Results Of the 65 cases, 41 were malignant and 24 were benign. The accuracy, sensitivity and specificity were 80.0% （52/65）, 87.8% （36/41）, and 66. 7% （16/24） for conventional color Doppler flow imaging, and 93.8M （61/65）, 97.6% （40/41）, 87.5% （21/24） for CEUS, respectively. The contrast-enhanced ultrasound of renal cell carcinoma showed a fast-in and fast-out model, and high and symmetric enhancement; most of renal angiomyolipoma showed a slowly-in and slowly-out model, and low and uniform enhancement. Conclusions Ultrasound contrast improved the diagnostic accuracy, and had important value in the diagnosis and differential diagnosis of benign and malignant renal masses.