比较超声造影诊断微小肾细胞癌(MRCC)及>15 mm小肾细胞癌(SRCC)的应用价值

 目的  探讨超声造影在检出和诊断微小肾细胞癌(minute renal cell carcinoma,MRCC)及>15 mm小肾细胞癌(small renal cell carcinoma,SRCC)中的应用价值及差异。方法  对经手术病理证实的39例MRCC(d≤15 mm)及197例>15 mm的SRCC (15 mm＜d≤30 mm)的常规超声及超声造影表现进行回顾性分析,计算病灶在常规超声及超声造影时的明显性积分并分别进行统计分析,观察MRCC及>15 mm的SRCC的超声造影表现并进行对比分析。结果  常规超声检查时,MRCC的明显性积分低于>15 mm的SRCC (P=0.000),超声造影后,两者明显性积分无明显差异(P=0.434),但均较常规超声明显上升(P=0.000,0.000),且MRCC明显性积分上升幅度明显大于>15 mm的SRCC (P=0.000)。比较MRCC及>15 mm的SRCC超声造影表现特征、病灶增强方式、峰值强度及减退方式无明显差异(P=0.949,0.472,0.128),MRCC显示瘤周假包膜及不均匀强化特征的比例明显低于>15 mm的SRCC (P=0.002,0.002)。结论  超声造影对MRCC检出率的提高优于>15 mm的SRCC,但能为>15 mm SRCC的诊断提供更多有用信息。

The comparision of the value of contrast-enhanced ultrasound in the diagnosis of minute renal cell carcinoma (MRCC) and small renal cell carcinoma (SRCC) larger than 15 mm in diameter

Objective  To investigate the value of contrast-enhanced ultrasound (CEUS) in the detection and diagnosis of minute renal cell carcinoma (MRCC) and small renal cell carcinoma (SRCC) larger than 15 mm in diameter. Methods  The conventional ultrasound (US) and CEUS features of 39 cases of MRCC (d≤15 mm) and 197 cases of SRCC larger than 15 mm (15 mm＜d≤30 mm) were retrospectively analyzed. The scores of visibility of lesion on conventional US and CEUS were counted and compared, the enhancement features of MRCCs and SRCCs larger than 15 mm were observed and analyzed comparatively. Results  The scores of visibility of MRCCs were lower than that of SRCC larger than 15 mm on conventional US (P=0.000), while it had no significant difference between MRCCs and CEUS (P=0.434). The scores of visibility of both MRCCs and SRCCs larger than 15 mm on CEUS were significant higher than that on conventional US (P=0.000,0.000), meanwhile the improvement of the scores of visibility for MRCCs were significant higher than that for SRCCs larger than 15 mm (P=0.000).The enhancement features of flow-in patterns, enhancement degree, peak strength and flow-out patterns had no significant difference between MRCCs and SRCCs larger than 15 mm (P=0.949,0.472 and 0.128,respectively). The enhancement features of heterogeneous enhancement and pseudocapsule were less frequently in MRCCs than that in SRCCs larger than 15 mm (P=0.002 and 0.002 respectively). Conclusions  CEUS performs better in improving the detection rate of MRCCs than that of SRCCs larger than 15 mm, while it provides more useful information for the diagnosis of SRCCs larger than 15 mm.