Kitamura Hiroshi, Fujimoto Hiroyuki, Tobisu Ken-Ichi, Mizuguchi Yasunori, Maeda Tetsuo, Matsuoka Naoki, Komiyama Motokiyo, Nakagawa Tohru, Kakizoe Tadao
Divisions of Urology and Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan.
Jpn J Clin Oncol. 2004 Feb;34(2):78-81. doi: 10.1093/jjco/hyh013.
We evaluated whether color Doppler ultrasound (US) had diagnostic accuracy equal to dynamic computed tomography (CT) and whether performing dynamic CT and Doppler US together would be more informative in preoperative diagnosis of renal solid tumors.
A total of 110 renal solid tumors smaller than 7 cm were evaluated with dynamic CT and Doppler US. We compared the enhancement and the color flow patterns with the histopathological subtypes.
Eighty-seven (95.6%) of 91 clear cell carcinomas showed rich enhancement in the cortical nephrographic phase (CNP) and 82 (90.1%) of them had color flow in the Doppler US. Of the total of 110 tumors, nine (8.1%) did not show color flow in spite of rich enhancement in the CNP. Conversely, eight (7.2%) of the 110 tumors showed color flow in spite of poor enhancement, including two chromophobe cell carcinomas and two metastatic renal tumors.
The enhancement pattern in dynamic CT and the color flow pattern in Doppler US were different among the subtypes of RCC. Color Doppler US had diagnostic accuracy equal to dynamic CT in most patients with renal solid tumors. Although Doppler US may play a unique role in the diagnosis of some renal parenchymal solid tumors, it is sufficient to perform dynamic CT alone for diagnosis of clear cell carcinoma.
我们评估了彩色多普勒超声（US）的诊断准确性是否等同于动态计算机断层扫描（CT），以及联合进行动态CT和多普勒US在肾实性肿瘤术前诊断中是否能提供更多信息。
对110个直径小于7 cm的肾实性肿瘤进行了动态CT和多普勒US评估。我们将增强表现和血流模式与组织病理学亚型进行了比较。
91例透明细胞癌中的87例（95.6%）在皮质肾造影期（CNP）表现为丰富强化，其中82例（90.1%）在多普勒US中有血流信号。在总共110个肿瘤中，9例（8.1%）尽管在CNP中强化丰富，但在多普勒US中未显示血流信号。相反，110个肿瘤中有8例（7.2%）尽管强化不佳，但显示有血流信号，包括2例嫌色细胞癌和2例转移性肾肿瘤。
肾细胞癌（RCC）各亚型在动态CT中的强化模式和多普勒US中的血流模式有所不同。在大多数肾实性肿瘤患者中，彩色多普勒US的诊断准确性等同于动态CT。尽管多普勒US在某些肾实质实性肿瘤的诊断中可能发挥独特作用，但对于透明细胞癌的诊断，单独进行动态CT就足够了。
