| 潘宏,聂芳,刘学会,周晓燕.CEUS鉴别诊断肾透明细胞癌和嫌色细胞癌[J].中国医学影像技术,2016,32(9):1423~1426 |
| CEUS鉴别诊断肾透明细胞癌和嫌色细胞癌 |
| CEUS in differential diagnosis of clear cell renal cell carcinoma and chromophobe renal cell carcinoma |
| 投稿时间：2015-03-21 修订日期：2016-06-20 |
| DOI：10.13929/j.1003-3289.2016.09.027 |
| 中文关键词: 癌,肾细胞 鉴别诊断 超声检查 造影剂 |
| 英文关键词:Carcinoma, renal cell Differential diagnosis Ultrasonography Contrast media |
| 基金项目:甘肃省科技支撑项目（144FKCA061）。 |
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| 中文摘要: |
| 目的 探讨CEUS对肾透明细胞癌（CCRCC）和嫌色细胞癌（ChRCC）的鉴别诊断价值。方法 收集接受肾脏CEUS检查并经术后病理证实为CCRCC的患者75例及ChRCC的患者26例。观察CCRCC和ChRCC的增强方式、增强程度、增强形态、假包膜征及病灶对局部淋巴结、肾包膜及肾静脉的侵犯情况，并绘制时间-强度曲线，获得校正的始增时间（ΔAT）、达峰时间（ΔTTP）和峰值强度（ΔPI），进行统计学分析。结果 CCRCC多表现高增强（41/75，54.67%）、弥漫性增强（54/75，72.00%）和不均匀增强（58/75，77.33%），56.00%（42/75）有假包膜征。ChRCC多表现为低增强（19/26，73.08%）、向心性增强（14/26，53.85%）和均匀增强（17/26，65.38%），61.54%（16/26）有假包膜征。CCRCC与ChRCC增强程度、增强方式及增强形态的差异均有统计学意义（P均<0.05），假包膜征检出率的差异无统计学意义（P>0.05）。CCRCC的ΔAT和ΔTTP与ChRCC比较，差异均无统计学意义（P均>0.05），而CCRCC的ΔPI明显高于ChRCC（P<0.001）。以ΔPI=0.05%为阈值鉴别诊断CCRCC和ChRCC的准确率最高，其敏感度为82.70%，特异度为100%，ROC曲线下面积为0.969。CCRCC出现肾周和（或）肾窦脂肪受累和肾门和（或）腹膜后淋巴结转移的百分率均高于ChRCC（P均<0.05）。结论 CCRCC和ChRCC具有不同的CEUS特征，有助于二者的鉴别诊断。 |
| 英文摘要: |
| Objective To explore the value of CEUS in differential diagnosis of clear cell renal cell carcinoma (CCRCC) and chromophobe renal cell carcinoma (ChRCC). Methods Totally 75 CCRCC patients and 26 ChRCC patients who received renal CEUS examination and confirmed by pathology after operation were collected. Enhanced pattern, degree, type, psuedocapsule and invasion of lesion to local lymph nodes, renal diolame and renal vein were observed. Corrected arrival time (ΔAT), time to peak (ΔTTP) and peak intensity (ΔPI) were obtained by time-intensity curve, and statistical analysis was carried out. Results CCRCC were mainly hyper-enhancement (41/75, 54.67%), diffusibility enhancement (54/75, 72.00%), nonuniform enhancement (58/75, 77.33%), and 56.00% (42/75) had psuedocapsule. ChRCC were mainly low enhancement (19/26, 73.08%), centripetal enhancement (14/26, 53.85%), homogeneous enhancement (17/26, 65.38%), and 61.54% (16/26) had psuedocapsule. There was statistical difference in enhanced pattern, type and degree between CCRCC and ChRCC (all P<0.05), but there was no statistical difference in detection rate of psuedocapsule (P>0.05). There were no statistical difference in ΔAT and ΔTTP between CCRCC and ChRCC (both P>0.05). ΔPI of CCRCC was significantly higher than that of ChRCC (P<0.001). Taking ΔPI=0.05% as the threshold to differential diagnosis of CCRCC and ChRCC, it had the highest accuracy rate, and sensitivity was 82.70%, specificity was 100%, the area under the ROC curve was 0.969. The percentage of CCRCC with perirenal and (or) renal sinus fat involvement, renal hilum and (or) retroperitoneal lymph node metastasis were both higher than those of ChRCC (both P<0.05). Conclusion CEUS characteristics between CCRCC and ChRCC are different, which are useful to the differential diagnosis. |
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