摘要
目的探讨超声造影(contrast-enhanced ultrasound,CEUS)在复杂性肾囊肿及肾透明细胞癌囊性变(clear renal cell carcinoma with cystic change,CRCCC)鉴别诊断中的应用价值。方法分析经病理证实为复杂性肾囊肿或CRCCC的82例患者(82个病灶)的声像图资料,观察其常规超声及CEUS特点,并按照Bosniak分级标准对病灶进行分级。结果病理证实36个病灶为复杂性肾囊肿,46个病灶为CRCCC。常规超声显示复杂性肾囊肿中9个(25.0%)为囊性团块,27个(75.0%)为囊实性团块,其中14个(38.9%)可测及彩色血流信号。CRCCC中2个(4.3%)为囊性团块,44个(95.7%)为囊实性团块,其中33个(75.0%)可测及彩色血流信号。CEUS显示复杂性肾囊肿中仅18个(50.0%)见囊壁或分隔增强,且达峰时呈等或低增强,9个(50.0%)与肾皮质同时减退;35个(97.2%)囊壁薄而规则,所有病灶囊壁均无结节增强,33个(91.7%)分隔厚度<1 mm。CRCCC中45个(97.8%)见囊壁或分隔增强,40个(88.9%)达峰时呈等或高增强,30个(66.7%)快于肾皮质减退;37个(80.4%)囊壁厚薄不均,24个(52.2%)可见囊壁结节样增强,28个(60.9%)分隔厚薄不均。CEUS后复杂性肾囊肿中33个(91.7%)分级为Ⅰ、Ⅱ级,而CRCCC中42个(91.3%)分级为Ⅲ、Ⅳ级。结论复杂性肾囊肿与CRCCC的CEUS表现有一定的差异性,CEUS应用Bosniak标准有助于二者的鉴别诊断。
Objective To investigate the value of contrast-enhanced ultrasound(CEUS)in differential diagnosis of complex renal cysts and clear renal cell carcinoma with cystic change(CRCCC).Methods The ultrasonographic datas of 82 lesions in 82 patients with complicated renal cysts or CRCCC confirmed by pathology were analyzed.The characteristics of conventional ultrasound and CEUS were observed and evaluated.The lesions were graded according to Bosniak classification criteria.Results Pathological examination showed that 36 cases were complicated renal cysts and 46 cases were CRCCC.Routine ultrasound showed there were 9 cases(25.0%)with cystic masses and 27 cases(75.0%)with solid and cystic masses in complex renal cysts,of which 14 cases(38.9%)could detect color flow signals.In CRCCC,2 cases(4.3%)were with cystic masses and 44 cases(95.7%)were with solid and cystic masses,of which 33 cases(75.0%)could detect color flow signals.CEUS showed that only 18 cases(50.0%)of the complex renal cysts showed enhancement of cystic wall or septum,with equal or low enhancement at the peak,9 cases(50.0%)accompanied by decrease of renal cortex,35 cases(97.2%)had thin and regular cystic wall,no enhancement of cystic wall in all lesions,and 33 cases(91.7%)had septal thickness less than 1 mm.Forty-five cases(97.8%)of CRCCC showed enhancement of cystic wall or septum,40 cases(88.9%)showed equal or high enhancement at peak,30 cases(66.7%)were faster than the decrease of renal cortex,37 cases(80.4%)showed uneven thickness of cystic wall,24 cases(52.2%)showed enhancement of cystic wall nodules,and 28 cases(60.9%)showed uneven thickness of septum.After CEUS,33 cases(91.7%)of complex renal cysts were classified as gradeⅠandⅡ,while 42 cases(91.3%)of CRCCC were classified as gradeⅢandⅣ.Conclusions The CEUS manifestations of complex renal cysts are different from those of CRCCC.The application of Bosniak criteria in CEUS is helpful for the differential diagnosis of complex renal cysts and CRCCC.
作者
孙培
黄备建
薛立云
李翠仙
郑逢洋
严丽霞
王文平
Sun Pei;Huang Beijian;Xue Liyun;Li Cuixian;Zheng Fengyang;Yan Lixia;Wang Wenping(Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Shanghai Institute of Imaging Medicine,Shanghai 200032,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2019年第12期1045-1049,共5页
Chinese Journal of Ultrasonography
基金
上海市自然科学基金(16ZR1433200)
上海科技发展基金(SHDC22015002)。
关键词
超声造影
复杂性肾囊肿
肾透明细胞癌囊性变
鉴别诊断
Contrast-enhanced ultrasound
Complex renal cysts
Clear renal cell carcinoma with cystic change
Differential diagnosis
