【摘要】 目的研究超声造影不同增强强度及定量参数在肾脏小肿瘤良恶性鉴别诊断中的价值。方法 118例肾脏小肿瘤患者行术前超声造影,采用Sono Liver超声造影分析软件进行量化分析,获得最大峰值强度(IMAX)、上升时间(RT)、达峰时间(TTP)、平均渡越时间(mTT)及曲线下面积(AUC)等参数,并与病理结果进行对照,比较不同增强强度及各参数指标对肾脏小肿瘤良恶性的诊断价值。结果注射造影剂后118例肾脏小肿瘤均增强,其中低增强28例(23.6%),包括恶性8例,良性20例;等增强30例(25.4%),包括恶性22例,良性8例;高增强60例(51.0%),包括恶性54例,良性6例。低增强肾脏小肿瘤超声造影诊断敏感性62.5%,特异性85.0%,准确率78.6%;等增强肾脏小肿瘤超声造影诊断敏感性81.8%,特异性75.0%,准确率80.0%;高增强肾脏小肿瘤超声造影诊断敏感性92.5%,特异性83.3%,准确率91.7%。低增强良、恶性肾脏小肿瘤超声造影定量参数IMAX、RT、mTT、AUC比较差异均无统计学意义;等增强及高增强恶性肾脏小肿瘤RT、mTT均小于良性病灶,IMAX、AUC均大于良性病灶,差异均有统计学意义(均P<0.05)。结论不同增强强度超声造影联合定量参数分析可为肾脏良恶性小肿瘤的诊断提供更多的信息。更多还原

【Abstract】 Objective To analyze the value of enhanced intensity and quantitative parameters of contrast-enhanced ultrasound(CEUS)in diagnosis of benign and malignant nephritic small tumors. Methods One hundred and eighteen patients of nephritic small tumors underwent preoperative CEUS. The CEUS quantitative parameters including maximum peak intensity(IMAX),rise time(RT),time of reaching peak time(TTP),mean transit time(mTT)and area under curve(AUC)were analyzed by using Sono Liver ultrasonic contrast analysis software. The results were compared with those of pathological results. The value of the enhanced intensity and quantitative parameters in diagnosis of benign and malignant nephritic small tumors were compared.Results After injection of contrast agents,118 nephritic small tumors were all enhanced. Among them,28 cases showed hypoenhancement(23.6%),including 8 malignant and 20 benign lesions. 30 cases showed isoenhancement(25.4%),including22 malignant and 8 benign lesions. 60 cases showed hypereenhancement(51.0%),including 54 malignant and 6 benign lesions.The sensitivity,specificity and accuracy of hypoenhancement were 62.5%,85.0% and 78.6%. The sensitivity,specificity and accuracy of isoenhancement were 81.8%,75.0% and 80.0%. The sensitivity,specificity and accuracy of hypereenhancement were92.5%,83.3% and 91.7%. The CEUS quantitative parameters of IMAX,RT,mTT and AUC had no significant difference between hypoenhanced benign and malignant tumors. Both RT and mTT of isoenhanced and hypereenhanced malignant lesions were less than those of benign lesions,while IMAX and AUC were more than those of benign lesions,there were significant differences(all P<0.05). Conclusion Different enhanced intensity combined with quantitative parameters can offer more information for diagnosis of benign and malignant nephritic small tumors.更多还原