CAJ | 학술논문

目的探讨声辐射力脉冲成像(ARFI)技术反映的肾癌硬度与超声造影反映的血流灌注之间的关系.方法对经手术病理证实的24例肾癌患者术前先行ARFI检查,声触诊组织成像(VTI)技术初步判断肿瘤硬度、大小和边界,声触诊组织量化(VTQ)技术测量肿瘤及距肿瘤边缘至少2 cm的正常肾皮质的剪切波速度(SWV),随后行超声造影检查,通过时间强度曲线分析肿瘤内造影剂灌注过程及强化程度,将ARFI反映的肿瘤硬度与超声造影反映的血流灌注信息进行对比.结果 24例肾癌中,肾透明细胞癌18例,乳头状细胞癌3例,嫌色细胞癌2例,肾集合管癌1例.VTI检查肿瘤呈现灰黑色18例,灰白色4例,等亮度2例；VTQ测量正常肾皮质SWV值(2.10±0.94)m/s,肾肿瘤SWV值(2.47±0.61)m/s,高于肾皮质者19例(79.2％),其中超声造影表现为高强化18例,低强化1例；低于肾皮质者5例(20.8％),其中超声造影表现为高强化2例,低强化3例.不同硬度的肾癌灌注程度不同,质地硬者灌注高,质地软者灌注低,差异有统计学意义(P＜0.05).结论 ARFI技术反映的肾癌硬度与超声造影反映的血流灌注之间存在一定的相关性.
목적 탐토성복사력맥충성상(ARFI)기술반영적신암경도여초성조영반영적혈류관주지간적관계.방법 대경수술병리증실적24례신암환자술전선행ARFI검사,성촉진조직성상(VTI)기술초보판단종류경도、대소화변계,성촉진조직양화(VTQ)기술측량종류급거종류변연지소2 cm적정상신피질적전절파속도(SWV),수후행초성조영검사,통과시간강도곡선분석종류내조영제관주과정급강화정도,장ARFI반영적종류경도여초성조영반영적혈류관주신식진행대비.결과 24례신암중,신투명세포암18례,유두상세포암3례,혐색세포암2례,신집합관암1례.VTI검사종류정현회흑색18례,회백색4례,등량도2례；VTQ측량정상신피질SWV치(2.10±0.94)m/s,신종류SWV치(2.47±0.61)m/s,고우신피질자19례(79.2％),기중초성조영표현위고강화18례,저강화1례；저우신피질자5례(20.8％),기중초성조영표현위고강화2례,저강화3례.불동경도적신암관주정도불동,질지경자관주고,질지연자관주저,차이유통계학의의(P＜0.05).결론 ARFI기술반영적신암경도여초성조영반영적혈류관주지간존재일정적상관성.
Objective To investigate the correlation between elasticity obtained with acoustic radiation force impulse(ARFI) and blood perfusion obtained with contrast enhanced ultrasound(CEUS) in renal carcinoma.Methods Tweenty-four patients with renal carcinoma confirmed by operation and pathology underwent ARFI and CEUS sequentially,got preliminary information of elasticity,size and border with virtual touch tissue imaging (VTI),shear wave velocity (SWV) of tumor and renal cortex at least 2centimeters from the tumor margin were measured with virtual touch tissue quantification (VTQ),and then the imaging characteristics were analyzed with time intensity curve (TIC).The elasticity obtained with ARFI were compared with the blood perfusion obtained with CEUS.Results Totally 24 cases included 18 renal cell carcinomas,3 papillary renal cell carcinomas,2 chromophobe cell renal carcinomas and 1 rena1collecting duct carcinoma.In VTI,18 appeared darker,4 appeared brighter,and 2 had the same brightness as renal cortex.The SWV of tumor and renal cortex were (2.47±0.61)m/s,(2.10±0.94) m/s,respectively,19 were stiffer than renal cortex (79.2％),among which 18 appeared hyper-enhancement and 1 appeared hypo-enhancement;5 were softer than renal cortex (20.8％),among which 2 appeared hyper-enhancement and 3 appeared hypo-enhancement in CEUS.Tumors with different elasticity had different enhancement,stiff cases appeared hyper-enhancement,soft cases appeared hypo-enhancement (P ＜ 0.05).Conclusions There is correlation between elasticity obtained with ARFI and blood perfusion obtained with CEUS in renal carcinoma