| 摘要: |
| 目的：分析超声造影在鉴别肾癌（RCC）亚型及血管平滑肌脂肪瘤（AML）中的诊断价值。方法：回顾性分析76例肾肿瘤患者，包括45例透明细胞癌（CCRCC）、9例乳头状癌（PRCC）、8例嫌色细胞癌（CHRCC）、14例AML，比较分析其常规超声征象、超声造影增强模式以及病变与周围正常肾实质之间感兴趣区域（ROI）的超声造影时间强度曲线（time-intensity curve，TIC）对比参数差值。结果： ① 在RCC与AML组之间，患者肿瘤内部回声高低、内部回声均匀性、生长方式、假包膜、血流信号、造影灌注方式、消退方式、增强后均匀性、有无环状高增强、△PI、△BI、△TTP均存在统计学差异（P均<0.05）；② 分别比较分析AML与RCC亚型，AML与CCRCC较易鉴别；AML与PRCC、CHRCC组间肿瘤内部回声、增强后均匀性、△BI存在统计学差异（P均<0.05）。在不同肾癌亚型之间，CCRCC组表现为慢退、高增强、环状高增强的比例高于PRCC及CHRCC组比例（P均<0.05），而PRCC与CHRCC组之间超声造影增强特征差异无统计学意义。 与PRCC、CHRCC组相比，CCRCC组的△PI与△AUC 均较大、△TTP 较小（P均<0.05），而在CHRCC与PRCC组间差异无统计学意义。此外，CCRCC组△BI稍低于PRCC组（P<0.05）；CHRCC的△Grad较PRCC组高，CHRCC的△BI较PRCC组低（P均<0.05）。结论：超声造影增强模式及其定量参数分析在鉴别肾癌亚型及AML中有一定的应用价值，可为临床术前决策和预后评估提供参考。 |
| 关键词: 肾癌亚型 超声造影 血管平滑肌脂肪瘤 鉴别诊断 |
| DOI： |
| 投稿时间：2022-09-20修订日期：2022-11-08 |
| 基金项目: |
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| Study on the differential diagnosis of renal cell carcinoma subtype and angiomyolipoma by contrast-enhanced ultrasound |
| FAN Ruiqi,JIA Chunmei,LI Tingting,WANG Jingjie,Mi Na,WANG Zhuoran |
| (Department of Ultrasound,First Hospital of Shanxi Medical University) |
| Abstract: |
| Objective To analyze the diagnostic value of contrast-enhanced ultrasonography in differentiating renal cell carcinoma (RCC) subtype and angiomyolipoma (AML). Methods 76 patients with renal tumors, including 45 cases of clear cell carcinoma (CCRCC), 9 cases of papillary carcinoma (PRCC), 8 cases of chromophobe cell carcinoma (CHRCC) and 14 cases of AML, were retrospectively analyzed. The conventional ultrasound signs, CEUS enhancement patterns and the contrast parameter difference of time intensity curve (TIC) between the lesion and the surrounding normal renal parenchyma were compared and analyzed. Results ① Between RCC and AML groups, there were statistical differences in tumor internal echo height, internal echo uniformity, growth mode, false envelope, blood flow signal, contrast perfusion mode, regression mode, uniformity after enhancement, presence or absence of circular high enhancement, △PI, △BI and △TTP (all P < 0.05); ②The subtypes of AML and RCC were compared and analyzed. AML and CCRCC were easy to distinguish; There were significant differences between AML, PRCC and CHRCC groups in tumor internal echo, homogeneity after enhancement and △BI (P <0.05). Among different renal cancer subtypes, the proportion of slow regression, high enhancement and circular high enhancement in CCRCC group was higher than that in PRCC and CHRCC groups (P < 0.05), but there was no significant difference in contrast-enhanced characteristics between PRCC and CHRCC groups. Compared with PRCC and CHRCC groups, the △PI and △AUC of CCRCC group were larger ，the △BI of CCRCC group were smaller(P < 0.05), but there was no significant difference between CHRCC and PRCC groups. In addition, the △BI in CCRCC group were slightly lower than those in PRCC group (P < 0.05); The △Grad of CCRCC and CHRCC was higher than that of PRCC group, The △BI of CCRCC and CHRCC was lower than that of PRCC group (all P < 0.05). Conclusions Contrast enhanced mode and quantitative parameter analysis have certain application value in differentiating renal cell carcinoma subtype and AML, and can provide reference for clinical preoperative decision-making and prognosis evaluation. |
| Key words: Renal cell carcinoma subtype Contrast-enhanced ultrasound angiomyolipoma（AML） differential diagnosis |
