Denys A, Hélénon O, Souissi M, Attlan E, Chrétien Y, Dufour B, Moreau J F
Service de Radiologie, Hôpital Necker, Paris.
J Radiol. 1991 Nov;72(11):599-608.
We report the results of a prospective study about the detection of tumoral neovascularization, the renal vein involvement and the characterization of renal tumors by color and pulsed doppler. Twenty-six renal tumors including 19 renal carcinomas and 7 benign tumors (2 angiomyolipomas, 2 oncocytomas, 2 complex cysts and one adenoma) were prospectively explored. Benign cysts were excluded from the study. The results were correlated to pathologic (24/26) and angiographic datas (24/26). Doppler ultrasonography seems to be an accurate method for the detection of a neovascularization (19 true-positives/19 vascularised tumors, no false-positive) but pulsed doppler (no false-negative) is more sensitive than color doppler imaging (3 false-negatives), the results of color doppler were improved by using a new software for the color detection of very low flow. Spectral analysis found 3 different types of doppler curves inside the masses, but all of them were observed in benign and malignant tumors. We did not find any correlation between the size of the tumor and the peak systolic velocity. The specificity of Doppler regarding the renal vein and inferior vena cava involvement seems to be good (no false-positive). But as, in our series, we do not have any case of main renal vein involvement, the sensitivity of this technique cannot be assessed.
我们报告了一项关于通过彩色和脉冲多普勒检测肿瘤新生血管形成、肾静脉受累情况以及肾肿瘤特征的前瞻性研究结果。前瞻性地探查了26个肾肿瘤,其中包括19个肾癌和7个良性肿瘤(2个血管平滑肌脂肪瘤、2个嗜酸细胞瘤、2个复杂性囊肿和1个腺瘤)。本研究排除了良性囊肿。将结果与病理数据(24/26)和血管造影数据(24/26)进行了对比。多普勒超声似乎是检测新生血管形成的一种准确方法(19个血管化肿瘤中有19个检测为真阳性,无假阳性),但脉冲多普勒(无假阴性)比彩色多普勒成像更敏感(彩色多普勒成像有3例假阴性),通过使用一种用于检测极低血流的彩色新软件,彩色多普勒的结果得到了改善。频谱分析在肿块内部发现了3种不同类型的多普勒曲线,但在良性和恶性肿瘤中均观察到了所有这些曲线。我们未发现肿瘤大小与收缩期峰值速度之间存在任何相关性。多普勒超声对于肾静脉和下腔静脉受累情况的特异性似乎良好(无假阳性)。但在我们的系列研究中,没有任何主肾静脉受累的病例,因此无法评估该技术的敏感性。