Park Byung Kwan, Kim Seung Hyup, Choi Hyuck Jae
Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, SNUMRC, Seoul, Korea.
Korean J Radiol. 2005 Jul-Sep;6(3):173-8. doi: 10.3348/kjr.2005.6.3.173.
We wanted to compare the imaging features of renal cell carcinoma (RCC) and their diagnostic accuracy on agent detection imaging (ADI) and grayscale ultrasonography (US).
Thirty non-consecutive patients (age range; 32-80 years, mean age; 53.7 years) with 30 RCCs were examined with gray-scale US and with ADI in conjunction with using SH U 508A. We described the imaging features of the renal tumors obtained from ADI according to their enhancement pattern, the intratumoral anechoic areas and the presence of any pseudocapsule. The imaging features and diagnostic accuracy of ADI and gray-scale US were then compared.
On the ADI exam, the RCCs were shown as being heterogeneous in 87% of the cases (26/30), homogeneous in 7% of the cases (2/30), and there was peripheral irregular enhancement in 7% of the cases (2/30). Intratumoral anechoic areas and pseudocapsule were seen in 87% and 77% of the RCCs on the ADI exam, whereas these features were seen in 53% and 17% of the cases on the gray-scale US, respectively. The diagnostic sensitivity, specificity, and accuracy for RCC with ADI were 97%, 93%, and 95%, respectively. However, those for RCC with using gray-scale US were 70%, 86%, and 78%, respectively. There was a significant difference for the diagnostic accuracy of RCC between ADI and gray-scale US (p < 0.05).
Agent detection imaging can help visualize the enhancement pattern of RCC and improve the diagnostic accuracy of this tumor by better displaying the intratumoral anechoic areas and the pseudocapsule than does the grayscale US.
我们希望比较肾细胞癌（RCC）的成像特征及其在造影剂增强成像（ADI）和灰阶超声检查（US）中的诊断准确性。
对30例患有30个肾细胞癌的非连续患者（年龄范围32 - 80岁，平均年龄53.7岁）进行灰阶超声和使用SH U 508A的造影剂增强成像检查。我们根据肾肿瘤在造影剂增强成像中的强化方式、瘤内无回声区以及是否存在假包膜来描述其成像特征。然后比较造影剂增强成像和灰阶超声的成像特征及诊断准确性。
在造影剂增强成像检查中，87%（26/30）的肾细胞癌表现为不均匀强化，7%（2/30）为均匀强化，7%（2/30）为周边不规则强化。在造影剂增强成像检查中，87%的肾细胞癌可见瘤内无回声区，77%可见假包膜；而在灰阶超声检查中，这些特征分别见于53%和17%的病例。造影剂增强成像对肾细胞癌的诊断敏感性、特异性和准确性分别为97%、93%和95%。然而，灰阶超声对肾细胞癌的诊断敏感性、特异性和准确性分别为70%、86%和78%。造影剂增强成像和灰阶超声对肾细胞癌的诊断准确性存在显著差异（p < 0.05）。
与灰阶超声相比，造影剂增强成像能够更好地显示肾细胞癌的强化方式，通过更清晰地显示瘤内无回声区和假包膜，提高对该肿瘤的诊断准确性。
