CAJ | 학술논문

目的分析比较肾脏良恶性占位性病变超声造影增强模式.方法对52例肾脏占位性病变患者共52个病灶进行超声造影,观察超声造影增强模式,分析肾脏恶性占位性病灶超声造影时间-强度曲线定量参数,包括峰值强度、达峰时间、曲线尖度、曲线下面积.采用配对t检验比较上述各参数在肾脏恶性占位性病灶与癌周正常肾皮质间的差异.结果52个肾脏占位性病灶中恶性42个,良性10个.42个恶性肾脏占位性病灶中,32个透明细胞癌以快进、明显高增强为主(28/32,87.5%);2个嫌色细胞癌中,1个表现为快进、明显高增强,另1个表现为慢进、低增强;4个乳头状细胞癌均表现为慢进、轻度高增强;4个移行细胞癌表现为快进、高增强.10个肾脏良性占位性病灶中6个肾血管平滑肌脂肪瘤以慢进、低增强为主(5/6,83.3%);3个肾囊肿始终无增强;1个肾球旁细胞瘤呈慢进、低增强.肾脏恶性占位性病灶的峰值强度、曲线下面积分别为(47.189±11.245)%、(3.893±2.587)/s,均高于癌周正常肾皮质的(38.563±9.030)%、(2.552±1.464)/s,且差异均有统计学意义(t值分别为-3.723、-3.035,P均<0.01);肾脏恶性占位性病灶的达峰时间为(34.196±14.996)s,早于癌周正常肾皮质的(41.365±17.700)s,且差异有统计学意义(t=2.124,P<0.05).肾脏恶性占位性病灶与癌周正常肾皮质的曲线尖度分别为(0.082±0.054)/s、(0.065±0.032)/s,差异无统计学意义(t=-1.672,P=0.112).结论肾脏占位性病变超声造影增强模式结合时间-强度曲线可为鉴别病变良恶性提供依据.
목적분석비교신장량악성점위성병변초성조영증강모식.방법대52례신장점위성병변환자공52개병조진행초성조영,관찰초성조영증강모식,분석신장악성점위성병조초성조영시간-강도곡선정량삼수,포괄봉치강도、체봉시간、곡선첨도、곡선하면적.채용배대t검험비교상술각삼수재신장악성점위성병조여암주정상신피질간적차이.결과52개신장점위성병조중악성42개,량성10개.42개악성신장점위성병조중,32개투명세포암이쾌진、명현고증강위주(28/32,87.5%);2개혐색세포암중,1개표현위쾌진、명현고증강,령1개표현위만진、저증강;4개유두상세포암균표현위만진、경도고증강;4개이행세포암표현위쾌진、고증강.10개신장량성점위성병조중6개신혈관평활기지방류이만진、저증강위주(5/6,83.3%);3개신낭종시종무증강;1개신구방세포류정만진、저증강.신장악성점위성병조적봉치강도、곡선하면적분별위(47.189±11.245)%、(3.893±2.587)/s,균고우암주정상신피질적(38.563±9.030)%、(2.552±1.464)/s,차차이균유통계학의의(t치분별위-3.723、-3.035,P균<0.01);신장악성점위성병조적체봉시간위(34.196±14.996)s,조우암주정상신피질적(41.365±17.700)s,차차이유통계학의의(t=2.124,P<0.05).신장악성점위성병조여암주정상신피질적곡선첨도분별위(0.082±0.054)/s、(0.065±0.032)/s,차이무통계학의의(t=-1.672,P=0.112).결론신장점위성병변초성조영증강모식결합시간-강도곡선가위감별병변량악성제공의거.
Objective To explore the enhancement patterns of renal masses by contrast enhanced ultrasonography( CEUS).Methods Fifty-two patients with renal masses were examined by CEUS .The enhancement patterns of renal masses were observed and the time-intensity curves of the malignant lesions were assessed,and obtained the perfusion parameters of the renal malignant lesions and the normal renal cortex of themselves,the perfusion parameters:the peak intensity, the time-to-peak,the sharpness of the curve,the area under the curve of the renal malignant lesions and the normal renal cortex of themselves were compared with the paired t test.Results The 52 masses included 42 malignant and 10 benign lesions confirmed by pathological examination .In the malignant lesions,most of the 32 renal clear-cell carcinomas (87.5%) presented “fast-in and hyper-enhanced significantly”.One renal chromophobe cell carcinoma displayed “fast-in and hyper-enhanced”,the other renal chromophobe cell carcinoma presented “slow-in and hypo-enhanced significantly”.The enhancement patterns of 4 papillary renal cell carcinomas were “slow-in and hyper-enhanced slightly”.Four transitional cell carcinomas showed “fast-in and hyper-enhanced”.In the benign lesions,the enhancement patterns of angiomyolipomas were mainly “slow-in and hypo-enhanced”.The renal cysts showed no enhancement .The peak intensity and area under the curve in the malignant lesions were higher than the normal renal cortex of themselves significantly [(47.189 ±11.245)%vs(38.563 ±9.030)%, (3.893 ±2.587)/s vs(2.552 ±1.464)/s,t=-3.723,-3.035,P<0.01].The time-to-peak was earlier than the normal renal cortex [(34.196 ±14.996) s vs (41.365 ±17.700) s,t =2.124, P <0.05]. Conclusion The enhancement patterns combined with time-intensity curves of renal masses can provide the basis for the differential diagnosis of lesions .