超声造影在肾脏良、恶性肿瘤中的鉴别诊断价值

发布时间：2018-04-03 21:13

本文选题：肾肿瘤　切入点：超声造影　出处：《宁夏医科大学》2017年硕士论文

【摘要】：目的探讨超声造影对肾脏良、恶性肿瘤的鉴别诊断价值。方法本研究对2015年6月至2016年11月67例肾脏占位性病变患者术前先行常规超声检查,通过观察病灶位置、大小、边界、形态、内部回声强度和均匀度及血流分布情况,做出肾肿瘤的定性诊断;然后再进行超声造影检查,观察造影剂开始显影、达峰和消退的全过程,结合Sono Liver造影分析软件得出的定量参数,包括峰值强度(IMAX%)、上升时间(RT)、达峰时间(TTP)和平均渡越时间(m TT),对肾肿瘤进行定性、定量分析后判断肿瘤良、恶性,并与增强CT定性诊断结果进行比较。以病理结果为金标准,分析比较肾脏良、恶性肿瘤的造影增强特征。结果 1.47例肾脏恶性肿瘤中,主要表现为同步、快速强化(38/47),强化程度多为高增强(33/47),增强均匀度多为不均匀增强(28/47);16例肾脏良性实性占位病变中,主要表现为晚于肾皮质的强化(11/16),强化程度多为低增强(12/16),增强均匀度多为均匀增强(14/16),肾脏良恶性肿瘤的造影增强模式、增强强度、增强均匀度差异均具有统计学意义(P0.01)。2.肾脏恶性病灶的IMAX高于正常肾皮质,RT、TTP和m TT均早于正常肾皮质,差异均具有统计学意义(P0.05);肾脏恶性病灶的IMAX高于良性病灶,RT和m TT均早于良性病灶,差异均具有统计学意义(P0.05)。3.超声造影诊断肾脏肿瘤的敏感度91.5%,特异度75.0%,准确性86.6%;增强CT定性诊断肾脏肿瘤的敏感度93.6%,特异度80.0%,准确性86.6%。结论 1.肾脏肿瘤的超声造影增强模式、增强强度、增强均匀度可以为鉴别病灶的良、恶性提供依据。2.超声造影结合造影定量分析软件有助于肾脏良、恶性肿瘤的诊断和鉴别,为临床提供了有用的参考价值。
[Abstract]:Objective to evaluate the value of contrast-enhanced ultrasonography in differential diagnosis of renal benign and malignant tumors.Methods from June 2015 to November 2016, 67 patients with renal space-occupying lesions were examined by conventional ultrasound before operation. The location, size, boundary, shape, intensity and uniformity of internal echo and distribution of blood flow were observed.The qualitative diagnosis of renal tumor was made, and then contrast-enhanced ultrasound was performed to observe the whole process of contrast medium development, peak and regression, and the quantitative parameters obtained by Sono Liver analysis software.Including peak intensity IMAXT, rising time, TTP) and mean transit time (TTP), qualitative and quantitative analysis of renal tumors were carried out to determine the benign and malignant tumors, and compared with the qualitative diagnosis results of enhanced CT.The enhancement features of renal benign and malignant tumors were analyzed and compared with pathological results as gold standard.Results 1.The main manifestations of 47 cases of renal malignant tumors were synchronous, rapid enhancement of 38 / 47, enhancement degree of high enhancement of 33 / 47, enhancement uniformity of uneven enhancement of 28% 47% of 16 cases of benign solid lesions of the kidney. 2.The main manifestations were 11 / 16% enhancement later than the renal cortex, 12 / 16% enhancement degree, and 14% uniform enhancement uniformity degree. The enhancement pattern, intensity and uniformity of enhancement of benign and malignant renal tumors were significantly different (P 0.01 / 16).The IMAX of malignant renal lesions was earlier than that of normal renal cortex, and the IMAX of malignant renal lesions was earlier than that of benign ones (P 0.05).The sensitivity, specificity and accuracy of contrast-enhanced CT in the diagnosis of renal tumors were 91.5 and 75.0, respectively, and the sensitivity, specificity and accuracy of enhanced CT in the qualitative diagnosis of renal tumors were 93.6, 80.0 and 86.6, respectively.Conclusion 1.Contrast-enhanced mode, enhancement intensity and enhancement uniformity of renal tumors can provide evidence for differentiating benign and malignant lesions.Contrast-enhanced ultrasound combined with quantitative analysis software is helpful for the diagnosis and differential diagnosis of renal benign and malignant tumors and provides a useful reference value for clinical practice.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R737.11

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