肾透明细胞癌彩色多普勒与超声造影特点分析

目的：探讨肾透明细胞癌（CCRCC）彩色多普勒超声（CDFI）与实时超声造影（CEUS）的具体特征及实用性。方法：对手术后病理证实的34例CCRCC的CDFI和CEUS检查结果进行回顾性分析，总结其CDFI表现及CEUS模式下的增强特点。结果：①CCRCC的CDFI表现：血流丰富型10例，血流稀少型24例；诊断准确性为52.94%。②CCRCC的CEUS表现：共34例，CEUS增强模式有4种，快进快退（26/34）、快进慢退（6/34）、慢进慢退（1/34）及慢进快退（1/34），并以快进快退为主（x2=66.667，P＜0.01）；增强强度分为3种，分别为高强化（25/34）、等强化（5/34）、低强化（4/34），并以高强化为主（x2=37.147，P＜0.01）；强化形态分为环形强化和不均匀强化，两者差异无统计学意义（x2=2.118，P＞0.05）。CEUS诊断CCRCC的准确性为82.35%，与CDFI比较差异有统计学意义（x2=6.719，P＜0.05）。结论：CCRCC的实时CEUS表现具有一定的特征，比CDFI更敏感地显示CCRCC的血流灌注特点，有助于提高超声诊断信心。

Characteristic analysis of clear cell renal cell carcinoma by color Doppler ultrasonography and contrast-enhanced ultrasonography

Objective: To explore the imaging features between color Doppler flow imaging (CDFI) and contrast-enhanced ultrasonography (CEUS) in clear cell renal cell carcinoma, and evaluate the performance characteristics. Methods: The features of CDFI and CEUS of 34 CCRCC confirmed by operation and pathology were retrospectively analyzed, the characteristics of CDFI and the enhancement and wash out in different phases of CEUS were analyzed. Results: ①The imaging features of CDFI in CCRCC could be classified as two types, 10 cases of the CCRCC were rich in blood and the blood flow were not rich and in 24 cases. ②Enhancement patterns of renal clear cell carcinoma could be performed differently, and they were divided into four models. Twenty-six cases of the CCRCC indicated contrast enhancement patterns of fast in and fast out; six cases indicated that fast in and slow out; one case indicated that slow in and slow out; one case indicated that slow in and fast out. The degree of enhancement was divided into three types. Twenty-five cases of the CCRCC performed as hyper-enhancement; five cases performed as iso-enhancement; four cases performed as hypo-enhancement. The enhancement shape were mainly performed as two types, fourteen cases as rim enhancement and twenty cases as nonhomegeneous enhancement. The performance characteristics of CCRCC in the imaging of CEUS were fast in and fast out, the peak intensity, rim enhancement, nonhomegeneous enhancement. The diagnostic accuracy of CCRCC was 52.94% by CDFI and was 82.35% by CEUS, where significant difference was observed (P<0.05). Conclusion: CEUS shows some characteristic enhancement features, can display tumor vascularity and blood perfusion feature more sensitively than CDFI, and the confidence can be improved by the application of CEUS combined with CDFI.