肾细胞癌常规超声及超声造影特征

目的 观察肾细胞癌（RCC）及其常见病理亚型的常规超声及超声造影（CEUS）特征。方法 纳入94例RCC（恶性组）及34例肾脏良性病变患者（良性组），将恶性组分为肾透明细胞癌（ccRCC）亚组（n=74）和肾乳头状细胞癌（pRCC）及肾嫌色细胞癌（cRCC）亚组（n=16）；比较良、恶性组及恶性组2亚组病灶常规超声及CEUS特征。结果 恶性组主要表现为低回声（63/94，67.02%）、快进（84/94，89.36%）、快退（58/94，61.70%）及高增强（68/94，72.34%），良性组主要表现为高回声（20/34，58.82%）、快进（22/34，64.71%）、慢退（16/34，47.06%）及高增强（15/34，44.12%）；组间病灶回声、CEUS增强方式、消退方式及增强强度差异均有统计学意义（P均<0.05）。恶性组内2亚组病灶增强程度差异具有统计学意义（P<0.05），ccRCC主要表现为高增强（61/74，82.43%），pRCC及cRCC主要表现为低增强（10/16，62.50%）。结论 RCC，尤其ccRCC超声多表现为低回声、快进、快退及高增强；常规超声及CEUS对术前诊断RCC有一定价值。

Renal cell carcinomas: Findings of conventional ultrasonography and contrast-enhanced ultrasonography

Objective To observe the manifestations of renal cell carcinomas (RCC) and common pathological subtypes in conventional ultrasonography and contrast-enhanced ultrasonography (CEUS). Methods Totally 94 patients pf RCC (malignant group) and 34 of benign renal lesions (benign group) were enrolled. According to subtypes of RCC, patients in malignant groups were further divided into clear cell RCC (ccRCC) subgroup (n=74) as well as papillary RCC (pRCC) and chromophobe RCC (cRCC) subgroup (n=16). The conventional ultrasonographic and CEUS features of RCC were compared between groups and subtypes. Results Lesions in malignant group mainly presented hypoecho (63/94, 67.02%), fast-in (84/94, 89.36%), fast-out (58/94, 61.70%) and hyper-enhancement (68/94, 72.34%), while in benign group mainly presented hyperecho (20/34, 58.82%), fast-in (22/34, 64.71%), slow-out (16/34, 47.06%) and hyper-enhancement (15/34, 44.12%). The echo, enhancement mode, wash-out mode and peak intensity were significantly different between benign and malignant groups (all P<0.05). In malignant group, ccRCC mainly showed hyper-enhancement (61/74, 82.43%), pRCC and cRCC mainly showed hypo-enhancement (10/16, 62.50%). There was significant difference of the degree of enhancement between ccRCC subgroup and pRCC+cRCC subgroup (P<0.05). Conclusion RCC, especially ccRCC, mainly showed hypoecho, fast-in, fast-out and hyper-enhancement. Conventional ultrasound and CEUS had certain value for preoperative diagnosis of RCC.