CAJ | 학술논문

目的：比较超声造影、增强CT及增强MRI对肾脏占位性病变的诊断价值。资料与方法对78例经常规超声诊断为肾脏占位性病变患者的80个病灶进行实时超声造影检查，39个行增强CT检查，28个行增强MRI检查，其中5个同时行增强CT及增强MRI检查。以病理结果为“金标准”，比较超声造影、增强CT及增强MRI诊断肾脏占位性病变良恶性的价值。结果80个病灶中，57个为恶性病变，23个为良性病变；超声造影诊断肾脏病变良恶性的敏感度、特异度、阳性预测值、阴性预测值分别为93.0%、69.6%、88.3%、80.0%；增强CT诊断肾脏病变良恶性的敏感度、特异度、阳性预测值、阴性预测值分别为96.4%、72.7%、90.0%、88.9%；增强MRI诊断肾脏病变良恶性的敏感度、特异度、阳性预测值、阴性预测值分别为86.4%、66.7%、90.5%、57.1%；3种检查诊断效果间差异无统计学意义（P>0.05）。结论超声造影、增强CT及增强MRI对于肾脏占位性病变良恶性的诊断效果相当，临床可以根据各个检查技术的特点，为不同的患者选择适宜的检查，联合应用两种检查方法为肾脏占位性病变的诊断提供了更丰富的信息。
목적：비교초성조영、증강CT급증강MRI대신장점위성병변적진단개치。자료여방법대78례경상규초성진단위신장점위성병변환자적80개병조진행실시초성조영검사，39개행증강CT검사，28개행증강MRI검사，기중5개동시행증강CT급증강MRI검사。이병리결과위“금표준”，비교초성조영、증강CT급증강MRI진단신장점위성병변량악성적개치。결과80개병조중，57개위악성병변，23개위량성병변；초성조영진단신장병변량악성적민감도、특이도、양성예측치、음성예측치분별위93.0%、69.6%、88.3%、80.0%；증강CT진단신장병변량악성적민감도、특이도、양성예측치、음성예측치분별위96.4%、72.7%、90.0%、88.9%；증강MRI진단신장병변량악성적민감도、특이도、양성예측치、음성예측치분별위86.4%、66.7%、90.5%、57.1%；3충검사진단효과간차이무통계학의의（P>0.05）。결론초성조영、증강CT급증강MRI대우신장점위성병변량악성적진단효과상당，림상가이근거각개검사기술적특점，위불동적환자선택괄의적검사，연합응용량충검사방법위신장점위성병변적진단제공료경봉부적신식。
Purpose To compare the value of contrast-enhanced ultrasound (CEUS), contrast-enhanced CT (CECT) and contrast-enhanced MRI (CEMRI) in the diagnosis of renal space-occupying lesions. Materials and Methods Seventy-eight patients whose 80 kidney space-occupying lesions were conifrmed by traditional ultrasound underwent CEUS examination. Among those patients, 39 patients also underwent CECT, 28 had CEMRI, and 5 had CECT and CEMRI examination together. Taken pathologic findings as gold standard, the value of conventional ultrasound, CEUS, CECT and CEMRI was compared in the diagnosis of renal space-occupying lesions. Results Among 80 renal masses, 57 lesions were malignant and the rest 23 lesions were benign. The diagnostic sensitivity, speciifcity, positive predictive value and negative predictive value were 93.0%, 69.6%, 88.3%, 80.0%for CEUS;those for CECT were 96.4%, 72.7%, 90.0%, 88.9%respectively;and for CEMRI were 86.4%, 66.7%, 90.5%, 57.1%respectively;and the diagnostic value among the three means showed no difference (P>0.05). Conclusion CEUS, CECT and CEMRI are all effective in the diagnosis of renal space-occupying lesions, We may select suitable examination means for patients according to their features. A combination of these techniques provides more information for the diagnosis of renal space-occupying lesions.