CAJ | 학술논문

目的比较良、恶性肾脏占位性病变超声造影(CEUS)和增强CT灌注特点,评价CEUS与增强CT对良、恶性肾脏占位性病变的诊断价值.方法回顾性分析山西医科大学第一医院2008年1月至2010年12月收治的52例肾脏占位性病变患者共52个病灶的CEUS与增强CT检查资料,并进行比较.所有患者均经手术和病理证实.结果52个肾脏占位性病灶中,恶性病灶42个,包括透明细胞癌32个(其中囊性肾癌4个),嫌色细胞癌2个,乳头状细胞癌4个,移行细胞癌4个;良性病灶10个,包括肾血管平滑肌脂肪瘤6个,肾囊肿3个,肾球旁细胞瘤1个.42个恶性肾脏占位性病灶CEUS及增强CT均以快进快退及高增强为主.10个良性肾脏占位性病灶CEUS均以慢进慢退及低增强为主,而增强CT则均以快进慢退及低增强为主. CEUS、增强CT诊断良、恶性肾脏占位性病变的敏感度、特异度及准确性分别为88.1%、80.0%、86.5%和90.5%、60.0%、82.7%,两种方法诊断效果间差异无统计学意义(Fisher精确概率检验,P值分别为1.000、0.628、0.780).结论 CEUS和增强CT在肾脏占位性病变良、恶性诊断中均有较高价值,两者结合有助于肾脏占位性病灶良、恶性的明确诊断.
목적비교량、악성신장점위성병변초성조영(CEUS)화증강CT관주특점,평개CEUS여증강CT대량、악성신장점위성병변적진단개치.방법회고성분석산서의과대학제일의원2008년1월지2010년12월수치적52례신장점위성병변환자공52개병조적CEUS여증강CT검사자료,병진행비교.소유환자균경수술화병리증실.결과52개신장점위성병조중,악성병조42개,포괄투명세포암32개(기중낭성신암4개),혐색세포암2개,유두상세포암4개,이행세포암4개;량성병조10개,포괄신혈관평활기지방류6개,신낭종3개,신구방세포류1개.42개악성신장점위성병조CEUS급증강CT균이쾌진쾌퇴급고증강위주.10개량성신장점위성병조CEUS균이만진만퇴급저증강위주,이증강CT칙균이쾌진만퇴급저증강위주. CEUS、증강CT진단량、악성신장점위성병변적민감도、특이도급준학성분별위88.1%、80.0%、86.5%화90.5%、60.0%、82.7%,량충방법진단효과간차이무통계학의의(Fisher정학개솔검험,P치분별위1.000、0.628、0.780).결론 CEUS화증강CT재신장점위성병변량、악성진단중균유교고개치,량자결합유조우신장점위성병조량、악성적명학진단.
Objective To compare the enhanced characteristics of renal masses with contrast-enhanced ultrasound(CEUS)and contrast-enhanced CT and to evaluate the diagnostic value of CEUS and contrast-enhanced CT in renal masses.Methods The CEUS and contrast-enhanced CT examination data of 52 patients with renal masses (52 lesions) treated in the First Hospital of Shanxi Medical University from January 2008 to December 2010 were analyzed retrospectively and compared .All patients were proved by operation and pathology .Results Among 52 lesions with renal masses,42 lesions were malignant,including 32 clear cell carcinomas (of which 4 lesions were cystic renal cell carcinomas ),2 chromophobe cell carcinomas ,4 papillary cell carcinomas and 4 transitional cell carcinomas;10 lesions were benign,including 6 renal angiomyolipomas,3 renal cysts and 1 renal juxtaglomerular cell tumor.Enhancement patterns of CEUS and contrast-enhanced CT in the majority of 42 renal malignant lesions showed ′fast-in and fast-out′and′hyper-enhanced′.The enhancement patterns of the majority of 10 renal benign lesions showed ′slow-in and slow-out′and ′hypo-enhanced′in CEUS and ′fast-in and slow-out′and ′hypo-enhanced′in contrast-enhanced CT.The diagnostic sensitivity,specificity,accuracy of benign and malignant space occupying renal lesions was 88.1%,80.0%and 86.5%for CEUS and 90.5%, 60.0%and 82.7%for contrast-enhanced CT respectively ,and there was no statistical significance (Fisher′s exact test,P=1.000,0.628 and 0.780,respectively).Conclusions CEUS and contrast-enhanced CT may also be of value in evaluating and differentiating renal tumors .The combination of CEUS with contrast-enhanced CT is helpful to obtain the definite diagnosis of renal masses .