Jamis-Dow C A, Choyke P L, Jennings S B, Linehan W M, Thakore K N, Walther M M
Department of Diagnostic Radiology, National Institutes of Health, Bethesda, Maryland 20892-1182, USA.
Radiology. 1996 Mar;198(3):785-8. doi: 10.1148/radiology.198.3.8628872.
To determine the sensitivities of computed tomography (CT) and ultrasound (US) for detection and characterization of surgically verified small renal lesions.
Twenty-one patients with von Hippel-Lindau disease or hereditary papillary renal cancer underwent CT and US before partial nephrectomy or enucleation; 205 renal masses were removed (92% were <3 cm). Detection rates and accuracy of CT and US in the characterization of renal morphology were correlated with lesion size.
CT and US detection rates for lesions of 0-5 mm were respectively 47% and 0%; 5-10 mm, 60% and 21%; 10-15 mm, 75% and 28%; 15-20 mm, 100% and 58%; 20-25 mm, 100% and 79%; and 25-30 mm, 100% and 100%. Among the lesions 10-35 mm, 80% and 82% were correctly characterized with CT and US, respectively.
A substantial proportion of lesions under 1 cm were not detected with either modality. Neither CT nor US was superior in the characterization of lesions 3 cm or less. CT and particularly US screening studies in patients with von Hippel-Lindau disease should be interpreted cautiously because missed or mischaracterized small renal lesions are a frequent problem in these patients.
确定计算机断层扫描（CT）和超声（US）检测及鉴别经手术证实的小肾病变的敏感度。
21例患有冯·希佩尔-林道病或遗传性乳头状肾癌的患者在接受部分肾切除术或肿瘤剜除术前接受了CT和US检查；共切除205个肾肿块（92%的肿块直径小于3厘米）。CT和US对肾形态特征的检测率及准确性与病变大小相关。
CT和US对0至5毫米病变的检测率分别为47%和0%；5至10毫米病变，分别为60%和21%；10至15毫米病变，分别为75%和28%；15至20毫米病变，分别为100%和58%；20至25毫米病变，分别为100%和79%；25至30毫米病变，均为100%。在10至35毫米的病变中，CT和US分别正确鉴别了80%和82%的病变。
两种检查方式均未检测出相当比例的1厘米以下病变。对于3厘米及以下的病变，CT和US在鉴别方面均无优势。对于患有冯·希佩尔-林道病的患者，CT尤其是US筛查结果的解读应谨慎，因为漏诊或错误鉴别小肾病变在这些患者中是常见问题。
