Li Qiuyang, Tang Jie, He Enhui, Li Yanmi, Zhou Yun, Wang Baojun
Department of Ultrasound, Chinese People's Liberation Army General Hospital, Beijing, China.
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Oncotarget. 2017 Aug 10;8(41):70883-70889. doi: 10.18632/oncotarget.20151. eCollection 2017 Sep 19.
To evaluate the value of contrast-enhanced ultrasonography (CEUS) in the differentiation of high and low grade urothelial carcinoma.
192 with 192 bladder lesions, including 110 high grade urothelial carcinoma and 82 low grade urothelial carcinoma were examined by CEUS. Among 192 tumors, enhancement patterns of 96 tumors between August 2010 and December 2012 were analyzed retrospectively. Then from January 2013 to April 2015, compared with CEUS was performed on 96 tumors for prospective differential diagnosis. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value were assessed.
With the CEUS view, dominant enhancement patterns were revealed as fast wash-in and slow wash-out for high grade urothelial carcinoma, fast wash-in and fast wash-out for low grade urothelial carcinoma, respectively. At CEUS, the prospective differentiation of bladder tumors showed sensitivity 86% , specificity 90%, accuracy 88%, positive predictive value 92%, and negative predictive value 82% for high grade tumors, while sensitivity 85% , specificity 89%, accuracy 88%, positive predictive value 85% and negative predictive value 89% for low grade tumors, respectively.
Our study demonstrates the great potential of CEUS in the differentiation of high and low grade urothelial carcinoma. Since CEUS is an effective, inexpensive, and non-invasive method. It could be a reliable tool in the evaluation of patients with bladder tumors.
评估超声造影（CEUS）在鉴别高级别和低级别尿路上皮癌中的价值。
对192例膀胱病变患者（包括110例高级别尿路上皮癌和82例低级别尿路上皮癌）进行CEUS检查。回顾性分析2010年8月至2012年12月间192例肿瘤中的96例肿瘤的增强模式。然后在2013年1月至2015年4月期间，对另外96例肿瘤进行CEUS前瞻性鉴别诊断，并评估其敏感性、特异性、准确性、阳性预测值和阴性预测值。
在CEUS图像上，高级别尿路上皮癌的主要增强模式为快进慢出，低级别尿路上皮癌的主要增强模式为快进快出。在CEUS检查中，膀胱肿瘤的前瞻性鉴别诊断显示，高级别肿瘤的敏感性为86%，特异性为90%，准确性为88%，阳性预测值为92%，阴性预测值为82%；低级别肿瘤的敏感性为85%，特异性为89%，准确性为88%，阳性预测值为85%，阴性预测值为89%。
我们的研究表明CEUS在鉴别高级别和低级别尿路上皮癌方面具有巨大潜力。由于CEUS是一种有效、廉价且无创的方法，它可能成为评估膀胱肿瘤患者的可靠工具。
