CAJ | 학술논문

目的：探讨肾脏多房状囊性占位灶内分隔的彩色多普勒以及超声造影表现对多房囊性肾癌及多房肾囊肿的诊断价值。方法：对53例（共54个病灶）经手术病理证实为多房状囊性肾癌以及多房状肾囊肿的患者进行超声检查，同时对该组24例患者进行超声造影（共24个病灶）检查，采用ROC曲线对病灶内分隔数目、厚度、分隔上的血流以及分隔的超声造影特征进行分析。结果：通过对本组53例患者共54个病灶内分隔数目、厚度以及分隔上血流的ROC曲线分析，病灶内分隔数目≥5条、3 mm<厚度≤4 mm及分隔上出现条状血流时其诊断囊性肾癌的特异度较高（分别为86%、95%、86%）。三者曲线下面积显示均具有较高的诊断价值（Az分别为0.7621、0.8331、0.7962）。而分隔数目等于4条，2 mm<厚度≤3 mm以及分隔出现点状血流时虽可作为诊断的最佳临界值，14例多房状囊性肾癌与10例多房状肾脏囊肿内分隔超声造影开始增强时间分别为（11.2±3.4）s及（18.4±4.5） s，达峰时间分别为（21.7±3.8）s及（37.8±8.0）s，开始消退时间分别为（32.1±4.0）s及（51.3±9.0）s，二者之间比较差异均具有统计学意义（t或t'值分别为4.47、5.90、6.31，P<0.05）。结论：多房状肾囊性占位灶内分隔数目、厚度以及分隔上血流超声表现对多房状囊性肾癌诊断具有较高的特异度，ROC曲线显示具有较高诊断价值，病灶内分隔的超声造影表现有助于多房状囊性肾癌与多房状肾囊肿的鉴别。
목적：탐토신장다방상낭성점위조내분격적채색다보륵이급초성조영표현대다방낭성신암급다방신낭종적진단개치。방법：대53례（공54개병조）경수술병리증실위다방상낭성신암이급다방상신낭종적환자진행초성검사，동시대해조24례환자진행초성조영（공24개병조）검사，채용ROC곡선대병조내분격수목、후도、분격상적혈류이급분격적초성조영특정진행분석。결과：통과대본조53례환자공54개병조내분격수목、후도이급분격상혈류적ROC곡선분석，병조내분격수목≥5조、3 mm<후도≤4 mm급분격상출현조상혈류시기진단낭성신암적특이도교고（분별위86%、95%、86%）。삼자곡선하면적현시균구유교고적진단개치（Az분별위0.7621、0.8331、0.7962）。이분격수목등우4조，2 mm<후도≤3 mm이급분격출현점상혈류시수가작위진단적최가림계치，14례다방상낭성신암여10례다방상신장낭종내분격초성조영개시증강시간분별위（11.2±3.4）s급（18.4±4.5） s，체봉시간분별위（21.7±3.8）s급（37.8±8.0）s，개시소퇴시간분별위（32.1±4.0）s급（51.3±9.0）s，이자지간비교차이균구유통계학의의（t혹t'치분별위4.47、5.90、6.31，P<0.05）。결론：다방상신낭성점위조내분격수목、후도이급분격상혈류초성표현대다방상낭성신암진단구유교고적특이도，ROC곡선현시구유교고진단개치，병조내분격적초성조영표현유조우다방상낭성신암여다방상신낭종적감별。
Objective: To investigate the diagnostic values of separated renal multi-locular cystic lesions color Doppler ultra-sound and contrast-enhanced ultrasound performance in multi-locular cystic renal cell carcinoma and cysts. Methods:A total of 53 pa-tients (54 lesions) with multi-locular cystic renal cell carcinoma and cysts were included in the study. The presence of carcinoma and cysts was confirmed via histopathology and tested using ultrasound. Contrast-enhanced ultrasound was applied in 24 (24 lesions) of the total number of patients, and the receiver operating characteristic (ROC) curve was used to analyze the numbers of separation, thick-ness, and type of blood flow patterns of the lesions. The contrast-enhanced ultrasound characteristics were also analyzed. We analyzed the diagnostic value of the color Doppler ultrasound in the separated renal multilocular cystic lesions and the contrast-enhanced ultra-sound performance in multi-locular cystic renal cell carcinoma and cysts. Results:Based on the analysis of the ROC curves of the sepa-ration number, thickness, and type of the blood flow of the lesions in 53 patients (54 lesions), the diagnostic specificity was relatively higher in the lesions where the separation number was≥5 strips (86%), the thicknesses were>3 and≤4 mm (95%), and blood flow was band-like (86%). The areas under the curve of the three indexes were 0.7621, 0.8331, and 0.7962, respectively, which indicate high diagnostic values. The separation number of 4 strips, the thicknesses of>2 and≤3 mm, and the point-like blood flow could be used as critical values for the diagnosis. The contrast enhancement, enhancement peak, and disappearance were (11.2 ± 3.4), (21.7 ± 3.8), and (32.1±4.0) s in 14 patients with multi-locular cystic renal cell carcinoma and (18.4±4.5), (37.8±8.0), and (51.3±9.0) s in 10 patients with multi-locular renal cysts, with statistically significant differences (t=4.47, t'=5.90, t'=6.31, respectively;P<0.05). Conclusion:The sepa-ration number, thickness, and type of blood flow of lesions have relatively higher specificity in multi-locular renal cysts than in multi-locular cystic renal cell carcinoma. The ROC curves show a high diagnostic value. Contrast-enhanced ultrasound of the lesions helped in the differential diagnosis of multi-locular cystic renal cell carcinoma and renal cysts.