CAJ | 학술논문

目的探讨实时三维超声造影(RT-3D-CEUS)评估肾透明细胞癌的应用价值.方法经病理证实的肾透明细胞癌患者35例,在术前接受常规超声(US)、二维超声造影(2D-CEUS)及RT-3D-CEUS检查,术后获得明确病理诊断.采用3分评分法(1分为最佳)对所有受试者的病灶可辨度、病灶立体感及肿瘤血管空间结构进行评价,将三种检查方式的评价结果进行比较.同时对RT-3D-CEUS评价肾透明细胞癌病灶立体感及肿瘤血管空间结构进行重复可靠性检验.结果 US、2D-CEUS及RT-3D-CEUS三种方式对肾透明细胞癌具有良好病灶可辨度(即1分)的病例数分别为17例(48.57％)、29例(82.86％)和32例(91.43％),总体之间差异有统计学意义(x2=19.352,P=0.001).两两比较结果显示,2D-CEUS与RT-3D-CEUS之间差异无统计学意义(x2=1.348,P=0.510),而US的病灶可辨度显著低于其他两种方法(P＜0.0125).对于病灶立体感及肿瘤血管空间结构而言,US、2D-CEUS及RT-3D-CEUS评分为1分者分别为7例(20.00％)、12例(34.29％)和30例(85.71％),总体之间差异有统计学意义(x2=34.146,P=0.000).RT-3D-CEUS显著高于其他两种方法(P＜0.0125).RT-3D-CEUS评价肾透明细胞癌病灶立体感及肿瘤血管空间结构在观察者内部及观察者之间均具有较高的重复可靠性.结论 RT-3D-CUES可以实时动态显示肾透明细胞癌的血供和空间立体关系,较常规超声具有更好的病灶空间整体评估能力,为术前准确评估肿瘤血供及体积提供了新方法.
목적 탐토실시삼유초성조영(RT-3D-CEUS)평고신투명세포암적응용개치.방법 경병리증실적신투명세포암환자35례,재술전접수상규초성(US)、이유초성조영(2D-CEUS)급RT-3D-CEUS검사,술후획득명학병리진단.채용3분평분법(1분위최가)대소유수시자적병조가변도、병조입체감급종류혈관공간결구진행평개,장삼충검사방식적평개결과진행비교.동시대RT-3D-CEUS평개신투명세포암병조입체감급종류혈관공간결구진행중복가고성검험.결과 US、2D-CEUS급RT-3D-CEUS삼충방식대신투명세포암구유량호병조가변도(즉1분)적병례수분별위17례(48.57％)、29례(82.86％)화32례(91.43％),총체지간차이유통계학의의(x2=19.352,P=0.001).량량비교결과현시,2D-CEUS여RT-3D-CEUS지간차이무통계학의의(x2=1.348,P=0.510),이US적병조가변도현저저우기타량충방법(P＜0.0125).대우병조입체감급종류혈관공간결구이언,US、2D-CEUS급RT-3D-CEUS평분위1분자분별위7례(20.00％)、12례(34.29％)화30례(85.71％),총체지간차이유통계학의의(x2=34.146,P=0.000).RT-3D-CEUS현저고우기타량충방법(P＜0.0125).RT-3D-CEUS평개신투명세포암병조입체감급종류혈관공간결구재관찰자내부급관찰자지간균구유교고적중복가고성.결론 RT-3D-CUES가이실시동태현시신투명세포암적혈공화공간입체관계,교상규초성구유경호적병조공간정체평고능력,위술전준학평고종류혈공급체적제공료신방법.
Objective To investigate the application value of real-time three-dimensional contrastenhanced ultrasonography (RT-3D-CEUS) for assessing the clear cell carcinoma of kidney.Methods Thirty five patients with renal clear cell carcinoma confirmed by pathology were enrolled in this study.The ultrasonography (US),two-dimensional contrast-enhanced ultrasonography (2D-CEUS) and RT-3D-CEUS were performed preoperatively.Pathological diagnosis was obtained after surgery.The identifiability,three dimensional features and vascular spatial relationship of renal lesions were evaluated by using a 3 point scoring method (1 =best).The results were compared among these three imaging models.Additionally,the intra-and inter-observer reliability of RT-3D-CEUS was further investigated in this study.Results Seventeen cases (48.57％),29 cases (82.86％) and 32 cases (91.43％) had a good identifiability of the renal lesion by US,2D-CEUS and RT-3D-CEUS respectively.There was a significant difference among these three models (x2 =19.352,P =0.001).No significant difference could be found between 2D-CEUS and RT-3D-CEUS (x2 =1.348,P =0.510),and the identifiability of US was inferior to 2D-CEUS and RT-3D-CEUS significantly (P ＜0.0125).For assessing the three dimensional features and vascular spatial relationship of renal lesions,7 cases (20.00 ％),12 cases (34.29 ％) and 30 cases (85.71 ％) had been evaluated as 1 score by US,2D-CEUS and RT-3D-CEUS respectively with a significant difference among these three models (x2 =34.146,P =0.000).RT-3D-CEUS was superior to the other two methods (P ＜0.0125).There was good intra-and inter-observer reliability of RT-3D-CEUS.Conclusions RT-3D-CEUS could display the three dimensional features and vascular spatial relationship of renal clear cell carcinoma which is superior to US and 2D-CEUS,and RT-3D-CEUS could be used as a novel method for assessing renal lesions.