Xue Li-Yun, Lu Qing, Huang Bei-Jian, Ma Jiao-Jiao, Yan Li-Xia, Wen Jie-Xian, Wang Wen-Ping
Department of Ultrasound, Zhongshan Hospital, Fudan University, Bldg 1#, 180 Fenglin Rd., Xuhui District, Shanghai, 200032, China.
Abdom Imaging. 2014 Dec;39(6):1274-83. doi: 10.1007/s00261-014-0171-4.
To assess the value of contrast-enhanced ultrasonography (CEUS) in evaluating cystic renal lesions compared with conventional ultrasound (US) and contrast-enhanced computed tomography (CECT).
One hundred and three patients with complex cystic renal masses underwent preoperative US and CEUS, among which 70 conducted CECT at our institution. The images were analyzed with the number of septa, septa and wall thickness and the presence of solid component, and final diagnosis was made.
In malignancies, CEUS demonstrated more septa, thicker wall or septa, and more solid components than US and CECT. CEUS permitted categorization of 51.7% (30/58) and 28.6% (10/35) of malignant tumors in higher grade than by US and CECT, respectively. In benign lesions, CEUS detected more septa than CECT and correctly diagnosed benign cysts which appeared as solid lesions in US. CEUS permitted downgrading of 71.1% (32/45) and 17.1% (6/35) of benign lesions compared to US and CECT. The diagnostic performance of CEUS was better than US for benign cystic lesions. The phenomenon that solid-like component by US did not enhance by CEUS was a strong predictor of benign disease, with a positive predictive value (PPV) of 100%. Enhancement of solid, soft tissue by CEUS was highly predictive of malignancy, with a PPV of 100%.
CEUS was superior to US and CECT in visualizing the number of septa septa and wall thickness, and the presence of solid component of cystic renal lesions. CEUS may play a similar role to CECT in the diagnosis of renal cystic lesions, and better than US.
与传统超声（US）和对比增强计算机断层扫描（CECT）相比，评估超声造影（CEUS）在评估肾囊性病变中的价值。
103例患有复杂肾囊性肿块的患者术前行US和CEUS检查，其中70例在本机构进行了CECT检查。分析图像的分隔数量、分隔及壁厚度以及实性成分的存在情况，并做出最终诊断。
在恶性病变中，CEUS显示出比分隔、壁厚或分隔更多，以及比US和CECT更多的实性成分。CEUS分别将51.7%（30/58）和28.6%（10/35）的恶性肿瘤分类为比US和CECT更高的级别。在良性病变中，CEUS检测到的分隔比CECT更多，并正确诊断出在US中表现为实性病变的良性囊肿。与US和CECT相比，CEUS分别将71.1%（32/45）和17.1%（6/35）的良性病变降级。对于良性囊性病变而言，CEUS的诊断性能优于US。US显示的类实性成分在CEUS中未增强这一现象是良性疾病的有力预测指标，阳性预测值（PPV）为100%。CEUS显示的实性软组织增强高度提示为恶性，PPV为100%。
在显示肾囊性病变的分隔数量、分隔及壁厚度以及实性成分的存在方面，CEUS优于US和CECT。在肾囊性病变的诊断中，CEUS可能发挥与CECT类似的作用，且优于US。
