乳头状肾癌和嫌色细胞癌的超声造影表现

目的 探讨超声造影在乳头状肾癌和嫌色细胞癌中的表现.方法 对22例22个经手术病理证实为乳头状肾癌和嫌色细胞癌的常规超声及超声造影声像图进行回顾性分析.常规超声观察肾占位大小、回声、边界、有无彩色血流信号.超声造影观察病灶的增强方式和增强时相,包括起始时间、达峰值时间、消退时间及病灶内部结构的增强表现.结果 本组22个肾占位经手术和病理证实乳头状肾癌13个和嫌色细胞癌9个.22个肿块最大直径范围1.1～14.2 cm,常规超声显示实质性肿块17个,囊实性肿块5个;18个病灶内发现彩色血流信号,4个未显示彩色血流信号.超声造影显示22个病灶均见增强,同步增强13个,缓慢增强9个,其延迟时间2～4 s,达峰值和实质期增强程度始终低于肾皮质;实质期快速消退16个,同步消退6个,共11个肿块周边显示假包膜.结论 缓慢增强和全期低增强对诊断乳头状肾癌和嫌色细胞癌有较大的帮助.

The Manifestation of Contrast-enhanced Ultrasonography in Renal Papillary Carcinoma and Chromophobe Carcinoma

Objective To investigate the manifestation of contrast-enhanced ultrasonography(CEUS) in renal papillary carcinoma and chromophobe carcinoma.Methods We retrospectively analyzed the ultrasonogram of routine ultrasound and CEUS in 22 cases of renal papillary carcinoma and chromophobe carcinoma which were proved by operation and pathology.The size,echo,boundary and color Doppler flow imaging(CDFI) signal of renal lesions were observed by routine ultrasound.Then CEUS showed the modality and phases of enhancement,including the arrival time,the peak,the washout time and the appearance of internal structures.Results Among the 22 cases of renal lesions proved by operations and pathololgy,there were 13 cases of papillary carcinoma and 9 cases of chromophobe carcinoma.The maximum diameter range of the 22 renal lesions was from 1.1 to 14.2 cm.Routine ultrasound showed 17 cases of parenchymatous masses and 5 cases of cystic masses.CDFI signal was observed in 18 cases,and other 4 cases did not show any blood stream signal.CEUS showed enhancement in all 22 cases of renal lesions,including 13 cases of isochronous enhancement and 9 cases of delayed enhancement.The delayed time was 2～4 seconds.The enhancement level of peak and parenchymal phase was lower than that of renal parenchyma all along.Sixteen cases showed fast washout in parenchymal phase,11 cases showed isochronous washout,and 11 cases showed pseudo-capsule.Conclusions Delayed enhancement and low enhancement level in all phases might be useful in the diagnosis of renal papillary carcinoma and chromophobe carcinoma.