超声造影在肾囊性肿块诊断中的应用

Contrast-enhanced Ultrasound for Diagnosis of Renal Cystic Mass.

机构信息

Department of Ultrasound, The First Affiliated Hospital of Nanchang University, No. 17 Yong Wai Zheng Street, Nanchang 330006, China.

College of Traditional Chinese Medicine, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.

出版信息

Curr Med Imaging. 2022;18(3):292-298. doi: 10.2174/1573405617666210719141831.

DOI:10.2174/1573405617666210719141831

PMID:34825641

Abstract

BACKGROUND

Cystic Renal Cell Carcinoma (CRCC) is often difficult to differentiate from complex cysts with sonographic manifestations of renal carcinoma. Contrast-Enhanced Ultrasound (CEUS) is a new technology, and its clinical utility in the diagnosis of renal cystic mass has not been established.

OBJECTIVE

The objective of this study is to analyze the characteristics of CEUS of renal cystic masses and to explore the clinical significance and value of CEUS in the diagnosis of CRCC.

METHODS

This study was a retrospective study. A total of 32 cystic masses from January 2018 to December 2019 were selected. The images of conventional Ultrasound (US) and CEUS were confirmed via surgical pathology. Routine US was used to observe the location, shape, size, boundary, cyst wall, internal echo, and blood supply of each cystic mass. CEUS observed contrast enhancement of the cyst wall, cystic septa, and solid nodules of cystic masses.

RESULTS

There were 26 cases of CRCC, 5 cases of renal cysts, and 1 case of renal tuberculosis. The enhancement pattern, degree of enhancement, and pseudocapsular sign by CEUS in benign and malignant masses had statistically significant differences (P<.05). In the diagnosis of CRCC, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 92.3%, 83.3%, 90.6%, 96.0%, and 71.4% for CEUS; 57.6%, 66.7%, 59.3%, 88.2%, and 26.7% for conventional US, respectively. CEUS had a higher sensitivity and accuracy than the conventional US (P<.05), although the diagnostic specificity, positive predictive value and negative predictive value of the two methods were not significantly different (P>.05).

CONCLUSION

CEUS is more accurate in the diagnosis of renal cystic masses, and it can be used as an effective imaging method.

摘要

背景

囊性肾细胞癌 (CRCC) 常难以与具有肾癌超声表现的复杂囊肿相鉴别。对比增强超声 (CEUS) 是一种新技术，其在诊断肾囊性肿块中的临床应用尚未确定。

目的

本研究旨在分析肾囊性肿块的 CEUS 特征，并探讨 CEUS 在 CRCC 诊断中的临床意义和价值。

方法

本研究为回顾性研究。选取 2018 年 1 月至 2019 年 12 月 32 个囊性肿块，经手术病理证实。常规超声 (US) 观察每个囊性肿块的位置、形态、大小、边界、囊壁、内部回声及血流供应，CEUS 观察囊性肿块的囊壁、囊间隔及实性结节的增强情况。

结果

CRCC 26 例，肾囊肿 5 例，肾结核 1 例。CEUS 良恶性肿块的增强方式、增强程度、假包膜征差异均有统计学意义（P<.05）。CEUS 诊断 CRCC 的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为 92.3%、83.3%、90.6%、96.0%、71.4%，常规 US 分别为 57.6%、66.7%、59.3%、88.2%、26.7%。CEUS 的灵敏度和准确度均高于常规 US（P<.05），但两者的诊断特异度、阳性预测值和阴性预测值差异均无统计学意义（P>.05）。