透明细胞肾细胞癌：增强超声特征与肿瘤大小的关系。

Clear cell renal cell carcinoma: contrast-enhanced ultrasound features relation to tumor size.

机构信息

Department of ultrasound, Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China.

出版信息

Eur J Radiol. 2010 Jan;73(1):162-7. doi: 10.1016/j.ejrad.2008.09.030. Epub 2008 Nov 8.

DOI:10.1016/j.ejrad.2008.09.030

PMID:18996660

Abstract

OBJECTIVES

To analyze the contrast-enhanced ultrasound (CEUS) features of clear cell renal cell carcinoma (CCRCC) in relation to tumor size.

MATERIALS AND METHODS

The CEUS appearance of 92 CCRCCs confirmed pathologically were retrospectively analyzed. Tumor size was stratified into six groups with a 1cm interval. For each lesion, the degree of enhancement, the homogeneity of enhancement and the presence of pseudocapsule sign were evaluated and compared with the pathologic findings.

RESULTS

The tumors of groups I-VI were counted for 13, 26, 21, 11, 10 and 11, respectively. All the CCRCCs mainly showed a marked enhancement, and there was no statistically significance between the degree of enhancement and tumor size (P>0.05). However, both homogeneity of enhancement and frequency of pseudocapsule correlated well with the tumor size (P<0.01). Homogeneous enhancement was shown in 85%, 65%, 19%, 9%, 0% and 0% of the tumors in the six groups, respectively. In tumors < or =3cm the frequency (72%) of homogeneity was significantly higher than in tumors >3cm (9%; P<0.01). The detection rate of pseudocapsule sign in the six group was 23%, 62%, 71%, 64%, 50% and 0%, respectively. The frequency of pseudocapsule sign was significantly higher in tumors 2.1-5cm than <2cm and >5cm (66%, 23%, 24%, respectively; P<0.01). On the pathologic examinations, the mean MVD was significantly higher in marked enhancement tumors than slight enhancement tumors (46.0+/-15.9, 27.5+/-8.3, respectively; P<0.01). Any tumors with a heterogeneous enhancement pattern were accompanied by intratumoral necrosis or cysts on histologic specimen. A pseudocapsule was seen at pathology in all the 46 cases with perilesional enhancement and 4 of 46 tumors without perilesional enhancement at CEUS.

CONCLUSION

CEUS features of CCRCCs vary with the size of the tumor, especially in the homogeneity of enhancement and the presence of pseudocapsule sign. CEUS is effective in demonstrating the sonographic visualization of tumoral characteristics.

摘要

目的

分析与肿瘤大小相关的透明细胞肾细胞癌（CCRCC）的超声造影（CEUS）特征。

材料与方法

回顾性分析了 92 例经病理证实的 CCRCC 的 CEUS 表现。将肿瘤大小分为 6 组，每组间隔 1cm。对每例病变的增强程度、增强均匀性及假性包膜征的存在进行评估，并与病理结果进行比较。

结果

I-VI 组肿瘤分别为 13、26、21、11、10 和 11 个。所有 CCRCC 主要表现为明显增强，增强程度与肿瘤大小之间无统计学意义（P>0.05）。然而，增强均匀性和假性包膜征的频率均与肿瘤大小密切相关（P<0.01）。6 组肿瘤中均匀增强分别为 85%、65%、19%、9%、0%和 0%。在肿瘤<或=3cm 时，均匀性频率（72%）显著高于肿瘤>3cm（9%；P<0.01）。6 组中假性包膜征的检出率分别为 23%、62%、71%、64%、50%和 0%。肿瘤 2.1-5cm 时的假性包膜征频率显著高于<2cm 和>5cm（66%、23%、24%，分别；P<0.01）。在病理检查中，明显增强肿瘤的平均 MVD 明显高于轻度增强肿瘤（46.0+/-15.9、27.5+/-8.3，分别；P<0.01）。任何增强模式不均匀的肿瘤在组织学标本中均伴有肿瘤内坏死或囊肿。CEUS 显示肿瘤周围增强的 46 例中均有假性包膜，CEUS 未见肿瘤周围增强的 46 例中有 4 例有假性包膜。