【摘要】 目的探讨肾细胞癌血管结构超声造影三维重建(three-dimensional contrast-enhanced ultrasound,3D-CEUS)的表现。方法本研究分析了101例经病理证实为肾细胞癌的超声造影三维重建图像资料。患者依次进行常规超声、超声造影、三维彩色血管能量成像(three-dimensional color power angiography,3D-CPA)、3D-CEUS检查并存储图像。应用QLAB工作软件进行3D-CEUS图像重建,按照血供丰富程度将3D-CEUS图像分为4型。统计采用STATA 7.0统计软件。结果 3D-CEUS可以清晰地提供肿瘤血管结构的立体图像,肾细胞癌主要表现为迂曲扩张的粗网状或杂乱树枝状,部分存在充盈缺损区及假包膜。不同病理类型肾细胞癌超声造影峰值强度(P<0.05)与内部均匀程度存在显著差异(P<0.05)。不同时相肾细胞癌3D-CEUS血管结构表现有显著差异(P<0.05)。不同病理类型肾细胞癌实质晚期3D-CEUS表现之间的差异有统计学意义(P<0.05)。超声造影可见21例(20.79%)肿瘤周边环状显著增强、缓慢减退的假包膜,其中三维重建后15例(14.85%)表现为减退较慢的薄壳状稍高回声。结论肾细胞癌超声造影三维重建是超声造影的有益补充。更多还原

【Abstract】 Objective To investigate the role of three-dimensional contrast-enhanced ultrasound(3D-CEUS) in showing vascular patterns of renal cell carcinomas.Methods The 3D -CEUS images of 101 renal cell carcinomas confirmed sequentially by pathology were retrospectively analyzed.3D-CEUS was performed after conventional ultrasound, contrast-enhanced ultrasound(CEUS) and three-dimensional color power angiography(3D-CPA).The 3D-CEUS images were reconstructed by QLAB workstation and classified into 4 types based on the blood abundance of the tumors.The data were analyzed by ST ATA 7.0.Results Three-dimensional reconstruction could provide clear stereoscopic views of the interested structures and morphological characteristics of lesions.Most of renal cell carcinomas showed tortuous expansive reticulations or irregular messy dendritic arborizations in 3D-CEUS,some displayed filling defect and pseudocapsule.There were significant differences in the enhancement level of peak(P<0.05)and the display of filling defect areas(P<0.05) among the different histologic subtypes of renal cell carcinoma,and the tumors showed distinct appearances at different phases of 3D-CEUS(P<0.05).The late parenchymal phase saw a significant difference in the appearances of different subtypes of RCCs(P<0.05).14.85%(15/101 cases)of the RCCs showed pseudocapsule in 3D-CEUS,compared with 20.79%of them in conventional CEUS.Conclusions 3D-CEUS can clearly depict stereoscopic structures and morphological characteristics of the lesions.It is a useful adjuvant of CEUS for the diagnosis of renal carcinomas.更多还原