超声造影联合强化CT在肾脏肿瘤诊断中的临床应用价值

发布时间：2018-03-18 15:26

本文选题：超声造影　切入点：强化CT　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探索超声造影联合强化CT在肾脏肿瘤诊断中的临床应用价值。方法:收集2015年3月至2017年1月份于河北医科大学第二医院泌尿外科住院并手术治疗患者101例。患者术前均完善超声造影以及强化CT检查。行超声造影检查的病人依据其病灶的强化及消退方式以及是否存在环状强化即“假包膜”等征象判断其良恶性。行强化CT检查的病人依据其是否存在“快进快出”等征象判断其良恶性。与患者术后病理结果相比较。结果:术后病理回报为恶性的73例病人中,超声造影考虑为恶性的为68例,CT考虑为恶性的为66例。术后病理回报为良性的28例病人中,超声造影诊断出约20例,强化CT诊断出为23例。超声造影诊断的敏感性、特异性、准确性分别为93.2%(68/73),71.4%(20/28),87.%(88/101);强化CT的敏感性、特异性和准确性分别为90.4%(66/73)、82.1%(23/28)和88.1%(89/101),而超声造影联合强化CT诊断肾脏肿瘤的敏感性、特异性和准确性分别为100%(73/73)、96.4%(27/28)和99.0%(100/101)。以术后病理为金标准,分别算出超声造影、强化CT及两种检查方法联合诊断肾脏肿瘤的准确率。三者之间,超声造影与强化CT相比在肾脏肿瘤病变的诊断能力方面无差异性(P0.05),而两者联合起来诊断肾脏肿瘤的能力高于其中任何一种方法单独诊断肾脏肿瘤的能力。结论:1超声造影在检查敏感性方面高于强化CT。2超声造影在检查的特异性和准确性上低于强化CT。3超声造影、强化CT两者结合可以提高肾脏肿瘤诊断的准确性。4对于患有肾肿瘤的病人术前均应常规行超声造影+强化CT检查,从而进一步提高肾肿瘤术前诊断的准确率,减少不必要的手术治疗,进而减少患者痛苦,减轻患者负担,节约医疗成本,避免过度医疗。
[Abstract]:Objective: to explore the clinical value of contrast-enhanced CT in the diagnosis of renal neoplasms. Methods: from March 2015 to January 2017, we collected 101 patients who were hospitalized and operated in the Department of Urology, the second Hospital of Hebei Medical University from March 2015 to January 2017. Cases: all the patients had perfect contrast echocardiography and enhanced CT before operation. The benign and malignant lesions were judged according to the enhancement and regression mode of the lesions and the existence of ring enhancement, that is, "false capsule". The patients undergoing enhanced CT scan were judged to be benign and malignant according to whether there were signs of "fast in and out". Results: among 73 patients whose pathological returns were malignant after operation, the pathological results were compared with those of the patients. Among the 28 cases with benign pathological return after operation, 20 cases were diagnosed by contrast-enhanced CT and 23 cases were diagnosed by enhanced CT. The accuracy was 93.2t / 71.4 / 71.4 / 87.75 / 88 / 101; the sensitivity, specificity and accuracy of the enhanced CT were 90.466 / 73 / 73 and 82.11 / 28, respectively; and the sensitivity, specificity and accuracy of contrast-enhanced CT in the diagnosis of renal tumors were 100 ~ 7373 / 96.27 / 28 and 99.070 / 100 / 101, respectively. The golden standard was post-operative pathology, and the sensitivity, specificity and accuracy of enhanced CT in the diagnosis of renal tumors were 100% 73 / 73% (96. 427 / 28) and 99. 0% / 100% 101% respectively, and the sensitivity, specificity and accuracy of enhanced CT in the diagnosis of renal tumors were 100% 10 1% and 99 0% / 100% 10 1%, respectively. The accuracy rates of contrast-enhanced CT and two methods of combined diagnosis of renal tumors were calculated respectively. There is no difference in the diagnostic ability of contrast-enhanced CT and contrast-enhanced CT in the diagnosis of renal neoplasms (P 0.05), but the ability to diagnose renal tumors in combination is higher than that of any of them alone. Conclusion: 1. The sensitivity of contrast-enhanced contrast-enhanced CT.2 was higher than that of enhanced CT.3 in specificity and accuracy. The combination of enhanced CT and enhanced CT can improve the accuracy of diagnosis of renal neoplasms. 4. In order to improve the accuracy of preoperative diagnosis of renal tumors, contrast-enhanced CT should be performed on all patients with renal tumors before operation. Reduce unnecessary surgical treatment, and then reduce the suffering of patients, reduce the burden of patients, save medical costs, avoid overtreatment.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R737.11;R730.44

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