Cai Yingyu, Du Lianfang, Li Fan, Gu Jiying, Bai Min
Department of Ultrasound, Shanghai First People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Department of Ultrasound, Shanghai First People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Ultrasound Med Biol. 2014 Jul;40(7):1387-93. doi: 10.1016/j.ultrasmedbio.2014.02.003. Epub 2014 Apr 24.
The purpose of this study was to investigate the value of quantitative assessment of enhancement in diagnosing renal cell carcinoma (RCC) with contrast-enhanced ultrasound (CEUS). A total of 73 solid renal parenchymal masses underwent both conventional ultrasound and CEUS. We compared the difference in maximum diameters on conventional ultrasound and CEUS between the benign and malignant groups. Enhancement features derived from a time-intensity curve were also analyzed. The diameters of renal cancer were found to be larger on CEUS than on conventional ultrasound (p < 0.05). When cutoff values of 4.74 s for washout time and 8.52% for enhancement intensity at 60 s for diagnosing RCCs were applied, the sensitivity, specificity and area under the receiver operating characteristic curve were 67.3%, 95.2%, 86.5% and 65.4%, 81.0%, 68.4%, respectively. The sensitivity and specificity for these two enhancement characteristics combined as a criterion for differentiating RCCs from benign lesions were 44.0% and 99.1%, respectively. Early washout in the area of maximal intensity in the interior of the lesion and prolonged washout in the whole area of the lesion are specific CEUS manifestations suggestive of RCC.
本研究旨在探讨超声造影（CEUS）定量评估强化在诊断肾细胞癌（RCC）中的价值。共有73个实性肾实质肿块接受了常规超声和CEUS检查。我们比较了良性和恶性组在常规超声和CEUS上最大直径的差异。还分析了时间-强度曲线得出的强化特征。发现肾肿瘤在CEUS上的直径大于常规超声（p<0.05）。当应用洗脱时间4.74秒和60秒时强化强度8.52%的临界值诊断RCC时，灵敏度、特异度和受试者操作特征曲线下面积分别为67.3%、95.2%、86.5%和65.4%、81.0%、68.4%。将这两个强化特征结合作为区分RCC与良性病变的标准时，灵敏度和特异度分别为44.0%和99.1%。病变内部最大强化区域的早期洗脱和病变整个区域的延迟洗脱是提示RCC的特异性CEUS表现。
