| 摘要: |
| 目的:探讨肿瘤超声及超声造影在肾上腺肿瘤患者中的临床价值及可行性。方法：选择2016年5月-2017年12月入院诊断的肾上腺肿瘤患者60例,所有患者均最终经手术病理组织学检查得到确诊。手术前患者均行肿瘤超声、超声造影检查,将肿瘤超声与超声造影检查结果与手术病理检查结果进行比较,分析肿瘤超声及超声造影早肾上腺肿瘤患者中的诊断价值及可行性。结果：60例肾上腺肿瘤均经过手术病理检查最终确诊,53例经手术治疗,7例经超声引导下穿刺活检确诊。肿瘤中,排在前三位的分别为：皮质腺瘤、嗜铬细胞瘤、髓样脂肪瘤,分别占：53.33%、13.33%和10.00%；肾上腺肿瘤患者均完成肿瘤超声与超声造影检查,肿瘤超声最终确诊53例；肿瘤超声联合超声造影检查最终确诊58例；肿瘤超声联合超声造影在肾上腺肿瘤中的诊断敏感性、特异性,均高于单一肿瘤超声和超声造影(P<0.05)；常规超声检查下确诊的30例腺瘤直径(9-37)mm,平均(23.14±4.61)mm,内部呈均质细点状回声,边界光滑、整齐,包膜完整；7例嗜铬细胞瘤直径(40-71)mm,平均(56.74±4.51)mm,内部呈均匀低回声,边界呈较高的清晰回声；5例髓样脂肪瘤直径(31-55)mm,平均(38.42±4.62)mm,圆形均质回声,形态规则、边界清。联合超声造影剂检查时造影剂均进入病灶部位,肿瘤边界更加清晰,且腺瘤、嗜铬细胞瘤与髓样脂肪瘤造影剂填充较快,达峰强度低于周围肝实质或与肝实质相当。腺瘤患者超声造影剂下周围均匀增强,内部存在散在造影剂；髓样脂肪瘤超声造影下不均匀增强,中央高而周围回声低。结论：肿瘤超声用于肾上腺肿瘤中能提高临床确诊率,而超声造影能显示肾上腺肿瘤血流灌注情况,能作为肿瘤超声的补充,肿瘤超声及超声造影联合能能实现肾上腺肿瘤的诊断与鉴别,值得推广应用。 |
| 关键词: 肿瘤超声 超声造影 肾上腺肿瘤 临床价值 可行性 |
| DOI： |
| 投稿时间：2019-12-19修订日期：2020-03-23 |
| 基金项目:黑龙江省卫生计生委科研课题项目 |
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| Diagnostic value and efficacy of tumor ultrasound and contrast-enhanced ultrasonography in adrenal tumors |
| liujirong,hanjiangtao,zhangjianying |
| () |
| Abstract: |
| Objective: To investigate the clinical value and feasibility of ultrasound and contrast-enhanced ultrasound in adrenal tumor patients. METHODS: A total of 60 patients with adrenal tumor diagnosed from May 2016 to December 2017 were selected. All patients were finally diagnosed by pathological histological examination. Before operation, all patients underwent ultrasound and contrast-enhanced ultrasound examination. The results of contrast-enhanced ultrasonography and contrast-enhanced ultrasonography were compared with the results of surgical pathology. The diagnostic value and feasibility of ultrasound and contrast-enhanced ultrasound in early adrenal tumors were analyzed. Results: 60 cases of adrenal tumors were diagnosed by pathological examination. 53 cases were treated by surgery and 7 cases were confirmed by ultrasound-guided biopsy. Among the tumors, the top three were cortical adenoma, pheochromocytoma, and myeloid lipoma, which accounted for 53.33%, 13.33%, and 10.00%, respectively; adrenal tumor patients completed ultrasound and contrast-enhanced ultrasound imaging. Finally, 53 cases were diagnosed with tumor ultrasound; 58 cases were diagnosed with combined ultrasound and contrast-enhanced ultrasound; the sensitivity and specificity of tumor ultrasound in adrenal tumors were higher than those of single tumor and ultrasound contrast (P<0.05). The diameters of the adenomas diagnosed by conventional ultrasonography were 9-37 mm, averaged 23.14±4.61 mm, and the internal appearance was homogeneous and fine-spot echoes. The borders were smooth and neat, and the capsule was complete; 7 pheochromocytoma diameters. (40-71) mm, average (56.74±4.51) mm, homogeneous hypoecho inside, clear echo at the boundary; diameter of myeloid lipoma in 31 cases (31-55) mm, average (38.42±4.62) mm , Circular homogenous echoes, regular rules, clear boundaries. In the ultrasound contrast agent examination, the contrast agent enters the lesion site, the boundary of the tumor is clearer, and the adenoma, pheochromocytoma, and myeloid lipoma are filled with the contrast agent faster, and the peak intensity is lower than the surrounding liver parenchyma or is equivalent to the liver parenchyma. . The adenoma patients were evenly enhanced around the contrast agent, and there was scattered intra-contrast agent; the myeloid lipomas were not evenly enhanced by contrast-enhanced ultrasound, and the center was high and the peripheral echo was low. Conclusion: Tumor ultrasound can improve the clinical diagnosis rate in adrenal tumors, and contrast-enhanced ultrasound can show the perfusion of adrenal tumors, which can be used as a supplement to tumor ultrasound. Tumor ultrasound and contrast-enhanced ultrasound can realize the diagnosis and identification of adrenal tumors, which is worthy of promotion. application. |
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