|本期目录/Table of Contents|

[1]汪朝阳,黄鹏飞,张晴,等.常规超声结合超声造影诊断肾占位性病变的价值[J].医学研究与战创伤救治(原医学研究生学报),2021,23(05):479-483.[doi:10.3969/j.issn.1672-271X.2021.05.007]
　WANG Zhao-yang,HUANG Peng-fei,ZHANG Qing,et al.The value of conventional ultrasound combined with contrast-enhanced ultrasound in the diagnosis of renal space occupying lesions[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2021,23(05):479-483.[doi:10.3969/j.issn.1672-271X.2021.05.007]
点击复制

常规超声结合超声造影诊断肾占位性病变的价值()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第23卷
期数:
2021年05
页码:
479-483
栏目:
临床研究
出版日期:
2021-09-20

文章信息/Info

Title:
The value of conventional ultrasound combined with contrast-enhanced ultrasound in the diagnosis of renal space occupying lesions
作者:
汪朝阳; 黄鹏飞; 张晴; 杨斌
作者单位：210002南京，东部战区总医院（原南京军区南京总医院）超声诊断科[汪朝阳（现在南京市中医院工作）、黄鹏飞、杨斌]；212000镇江，江苏大学附属人民医院超声诊断科（张晴）
Author(s):
WANG Zhao-yang1; HUANG Peng-fei1; ZHANG Qing2; YANG Bin1
（1.Department of Ultrasound Diagnosis, General Hospital of Eastern Theater Command, PLA, Nanjing 210002, Jiangsu, China；2. Department of Ultrasound Diagnosis, the Affiliated People’s Hospital of Jiangsu University, Zhenjiang 212000, Jiangsu, China）
关键词:
肾占位性病变; 超声造影; 常规超声; 高增强; 环状增强
Keywords:
renal space occupying lesions;  contrast-enhanced ultrasound;  conventional ultrasound;  high enhancement; annular enhancement
分类号:
R445.1；R692
DOI:
10.3969/j.issn.1672-271X.2021.05.007
文献标志码:
A
摘要:
目的探讨常规超声结合超声造影对诊断肾占位性病变的临床价值。方法回顾性分析2014年1月至2017年12月东部战区总医院收治的肾占位性病变患者174例的临床资料，所有患者术前均进行常规超声及超声造影检查，术后均行病理检查，其中恶性病变148例，良性病变26例。比较超声造影特征中肾良恶性占位的灌注情况、强化程度以及廓清情况，分析肾良恶性占位性病变的诊断价值。结果良性病变与恶性病变患者之间肿瘤大小、回声比较差异有统计学意义（P＜0.01），而性别、年龄、血流、边界比较差异无统计学意义（P＞0.05），其中肾血管平滑肌脂肪瘤在良性病变中占比最高[73%（19/26）]，其超声造影特征为皮质期等增强；肾透明细胞癌在恶性病变中占比最高[84%（125/148）]，其超声造影特征为皮质期高增强、周边环状假包膜及内部回声不均匀；两者在灌注方式及强化程度上差异具有统计学意义（P＜0.05）。超声造影诊断肾良恶性占位性病变的特异度为84.6%，灵敏度为97.3%，准确度95.4%。结论超声造影皮质期高增强、周边环状假包膜及内部回声不均匀是诊断肾恶性占位的重要特征，而皮质期等增强是诊断肾良性占位的主要特征。超声造影皮质期对肾占位性病变具有重要的诊断价值。
Abstract:
ObjectiveTo evaluate the clinical value of conventional ultrasound combined with contrast-enhanced ultrasound in the diagnosis of renal space occupying lesions.MethodsThe clinical data of 174 patients with renal space occupying lesions in Nanjing General Hospital of Nanjing military region from January 2014 to December 2017 were analyzed retrospectively. all patients were examined by routine ultrasound and contrast-enhanced ultrasound before operation. pathological examination was performed after operation, including 148 cases of malignant lesions and 26 cases of benign lesions. The perfusion, enhancement and clearance of benign and malignant renal space occupying lesions in contrast-enhanced ultrasonography were compared, and the diagnostic value of benign and malignant renal space occupying lesions was analyzed.ResultsThere was significant difference in tumor size and echo between patients with benign and malignant lesions (P<0.01), while there was no significant difference in sex, age, blood flow and boundary (P>0.05). Renal angiomyolipoma accounts for the highest proportion of benign lesions [73% (19 in 26)], and its contrast-enhanced ultrasound is characterized by cortical phase enhancement. Renal clear cell carcinoma accounted for the highest proportion of malignant lesions [84% (125 in 148)]. Its contrast-enhanced ultrasound was characterized by cortical phase hyperenhancement, peripheral annular pseudocapsule and uneven internal echo. There is a statistically significant difference between the two groups in the mode of perfusion and the degree of enhancement（P＜0.05）. The specificity, sensitivity and accuracy of contrast-enhanced ultrasound in the diagnosis of benign and malignant renal space occupying lesions were 84.6%, 97.3% and 95.4%, respectively.ConclusionThe high enhancement of contrast-enhanced ultrasound in cortical phase, peripheral annular pseudocapsule and uneven internal echo are important features in the diagnosis of malignant renal space occupying, while cortical phase enhancement is the main feature in the diagnosis of benign renal space occupying. The cortical phase of contrast-enhanced ultrasound plays an important role in the diagnosis of renal space-occupying lesions.

参考文献/References:

[1]Siegel RL, Miller KD, Fedewa SA, et al. Colorectal cancer statistics, 2017[J]. CA Cancer J Clin, 2017, 67(3):177-193..
[2]Sejima T, Iwamoto H, Masago T, et al. Oncological and functional outcomes after radical nephrectomy for renal cell carcinoma: a comprehensive analysis of prognostic factors[J]. Int J Urol, 2013, 21(1):382-389.
[3]张晴, 魏淑萍, 黄鹏飞, 等. 肾透明细胞癌病理分级与其超声特征的相关性分析[J]. 医学研究生学报, 2017, 30(10): 1071-1074.
[4]池永娥. 增强CT、增强MRI及超声造影对肾脏占位性病变的诊断价值对比研究[J]. 现代医用影像学, 2017, 26（5）:1293-1295.
[5]Thorelius L. Contrast-enhanced ultrasound: beyond the liver[J]. Eur Radiol, 2003, 13(Suppl 3): N91-108.
[6]Park BK, Kim SH, Choi HJ. Characterization of Renal Cell Carcinoma Using Agent Detection Imaging: Comparison With GrayscaleUS[J]. Korean J Radiol, 2005, 6(3): 173-178.
[7]Barr RG, Peterson C, Hindi A. Evaluation of indeterminate renal masses with contrast-enhanced US: a diagnostic performancestudy[J]. Radiology, 2014, 271(1): 133-142.
[8]Harvey CJ, Alsafi A, Kuzmich S, et al. Role of US contrast agents in the assessment of indeterminate solid and cystic lesions in native and transplantkidneys[J]. Radiographics, 2015, 35(5): 1419-1430.
[9]Pickhardt PJ, Lonergan GJ, Davis CJ Jr, et al. From the archives of the AFIP. Infiltrative renal lesions: radiologic-pathologic correlation. Armed forces institute of pathology[J]. Radiographics, 2000, 20(1): 215-243.
[10]姬文莉, 岳娜, 陈海霞, 等.肾嗜酸细胞腺瘤浸润性的病理特征分析[J]. 临床与实验病理学杂志, 2016, 32(6):648-651.
[11]席晨光, 范宇, 杨新宇, 等.16例后肾腺瘤的临床病理特点及鉴别诊断[J]. 北京大学学报(医学版), 2016, 48(4): 598-602.
[12]Ascenti G, Mazziotti S, Zimbaro G, et al. Complex cystic renal masses: characterization with contrast-enhanced US[J]. Radiology, 2007, 243(1):158-165.
[13]黄备建, 俞清, 周盛, 等.乳头状肾癌和嫌色细胞癌的超声造影表现[J]. 中国超声医学杂志,2009,25（11）:1060-1063.
[14]Tian W, Lu J, Jiao D, et al.An evaluation of the clinical di-agnostic value of contrast-enhanced ultrasound combined with contrast-enhanced computed tomography in space-ocupying lesions of thekidney[J]. Onco Targets Ther, 2017, 10:3493-3499.
[15]Wei SP, Xu CL, Zhang Q, et al.Contrast-enhanced ultrasound for differentiating benign from malignant solid small renal masses: comparison with contrast-enhanced CT[J]. Abdom Radiol, 2017, 42(8):2135-2145.
[16]田付丽, 魏淑萍, 史中青, 等. 超声造影对肾占位性病变的误诊分析[J]. 东南国防医药, 2019, 21(6): 646-648.

相似文献/References:

[1]司 芩,钱晓莉,仝 威,等.实时超声造影对肝硬化背景下占位病变的鉴别诊断[J].医学研究与战创伤救治(原医学研究生学报),2009,11(02):121.
　SI Qin,QIAN Xiao-li,TONG Wei,et al.Differential diagnosis of focal hepatic cirrhosis lesions using real-time contrast-enhanced ultrasound[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2009,11(05):121.
[2]朱 敏,刘高飞,李达文,等.超声造影与DSA在颈动脉狭窄诊断中应用[J].医学研究与战创伤救治(原医学研究生学报),2015,17(04):399.[doi:10.3969/j.issn.1672-271X.2015.04.020]
　ZHU Min,LIU Gao-fei,LI Da-wen,et al.Application of ultrasound contrast and dsa in patients with carotid artery stenosis[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2015,17(05):399.[doi:10.3969/j.issn.1672-271X.2015.04.020]
[3]陈刚,唐晓军,魏强,等.超声造影评价肝动脉化疗栓塞联合微波消融治疗中晚期肝癌疗效[J].医学研究与战创伤救治(原医学研究生学报),2016,18(05):531.[doi:10.3969/j.issn.1672-271X.2016.05.024]
[4]栾云,许华宁,吴意赟,等.超声造影对提高乳腺肿块系统分类准确性的价值评估[J].医学研究与战创伤救治(原医学研究生学报),2018,20(05):511.[doi:10.3969/j.issn.1672-271X.2018.05.014]
　LUAN Yun,XU Hua-ning,WU Yi-yun,et al.Evaluation the role of contrast-enhanced ultrasound in BI-RADS-US[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(05):511.[doi:10.3969/j.issn.1672-271X.2018.05.014]
[5]田付丽,魏淑萍,史中青,等.超声造影对肾占位性病变的误诊分析[J].医学研究与战创伤救治(原医学研究生学报),2019,21(6):646.[doi:10.3969/j.issn.1672-271X.2019.06.020]
[6]李宏波,李辉,黄辉,等.超声造影在颈动脉不同性质斑块评价中的应用价值[J].医学研究与战创伤救治(原医学研究生学报),2020,22(2):152.[doi:10.3969/j.issn.1672-271X.2020.02.009]
　LI Hong bo,LI Hui,HUANG Hui,et al.The valueof contrastenhanced ultrasound in the evaluation of different nature of carotid artery plaques[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2020,22(05):152.[doi:10.3969/j.issn.1672-271X.2020.02.009]
[7]徐捷,黄艳丽,冯念,等.超声造影鉴别诊断原发性小肝癌和肝硬化再生结节的价值[J].医学研究与战创伤救治(原医学研究生学报),2021,23(01):78.[doi:10.3969/j.issn.1672-271X.2021.01.001]
[8]戴云,徐超丽,宋秋怡,等.常规超声联合超声造影定量评价移植肾血流灌注对生存预后的预测价值[J].医学研究与战创伤救治(原医学研究生学报),2022,24(6):596.[doi:10.3969/j.issn.1672-271X.2022.06.008]
　DAI Yun,XU Chao-li,SONG Qiu-yi,et al.Predictive value of conventional ultrasoundcombined with quantitative parameters of contrast-enhanced ultrasound in evaluating kidney perfusion for predicting survival outcomes of patients after kidney transplantation[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(05):596.[doi:10.3969/j.issn.1672-271X.2022.06.008]

备注/Memo

备注/Memo:
-
更新日期/Last Update: 2021-10-11