声辐射力脉冲技术在肾肿瘤诊断中的应用价值

发布时间：2018-05-17 01:11

本文选题：超声检查 + 声辐射力脉冲　；参考：《实用医学杂志》2014年15期

【摘要】：目的:探讨声辐射力脉冲(acoustic radiation force impulse,ARFI)技术在肾肿瘤诊断中的应用价值。方法:对110例患者共110个肾肿瘤行声触诊组织成像(virtual touch tissue imaging,VTI)及声触诊组织量化(virtual touch tissue quantification,VTQ)检查,获取其VTI图像及肾肿瘤、患侧肾皮质、对侧肾皮质的剪切波速度(shear wave velocity,SWV)值,全部病例均经手术后病理证实。结果:病理证实良性肾肿瘤20个(血管平滑肌脂肪瘤18个,嗜酸细胞腺瘤2个),恶性肿瘤90个(透明细胞癌72个,嫌色细胞癌8个,乳头状癌6个,囊性肾癌4个)。VTI诊断肾恶性肿瘤的敏感度、特异性、阳性预测值、阴性预测值、准确率、Youden指数及ROC曲线下面积分别为71.11%(64/90)、70.00%(14/20)、91.43%(64/70)、35.00%(14/40)、70.91%(78/110)、41.11%、0.706。VTQ诊断肾恶性肿瘤的敏感度、特异性、Youden指数、ROC曲线下面积及最佳截断点值分别为66.70%、90.00%、56.70%、0.748、2.44 m/s。良性肿瘤与同侧肾皮质之间(P=0.000)、恶性肿瘤与同侧肾皮质之间(P=0.000)、良性肿瘤与恶性肿瘤之间(P=0.013)以及血管平滑肌脂肪瘤与透明细胞癌之间(P=0.022)SWV值差异有统计学意义,良性肿瘤与恶性肿瘤之间(P=0.010)以及血管平滑肌脂肪瘤与透明细胞癌之间(P=0.017)SWV比值差异有统计学意义。结论:ARFI技术可以提供肾肿瘤的VTI定性及VTQ定量的弹性信息,诊断准确度均达到中等,在肾肿瘤的诊断中有一定临床应用价值。
[Abstract]:Objective: to evaluate the value of acoustic radiation impulse radiation force impulse technique in the diagnosis of renal tumors. Methods: 110 renal tumors were examined by virtual touch tissue imaging (VTI) and acoustic palpation tissue quantitative touch tissue quantification (VTQs). The VTI images and renal tumors were obtained. The shear wave velocities of the affected renal cortex and the contralateral renal cortex were measured. All cases were confirmed by pathology after operation. Results: twenty benign renal tumors (18 angiomyolipoma, 2 eosinophils adenoma, 90 malignant tumors (72 clear cell carcinoma, 8 chromophobe cell carcinoma, 6 papillary carcinoma) were confirmed by pathology. The sensitivity, specificity, positive predictive value, negative predictive value, accurate rate of Youden index and area under the ROC curve of 4 patients with cystic renal cell carcinoma were 71.1164 / 90 and 70.0014 / 20 respectively. The sensitivity of diagnosis of renal malignancy was 91.43 / 64 / 70 / 40 / 70.9178 / 11 / 0.706.VTQ, respectively. The area under the ROC curve and the optimum cut-off point were 66.70 and 90.00m / s, 56.70 and 0.7482.44 m / s, respectively. There were significant differences in SWV between benign tumor and ipsilateral renal cortex, between malignant tumor and ipsilateral renal cortex, between benign tumor and malignant tumor, and between angiomyolipoma and clear cell carcinoma. There were significant differences in SWV ratio between benign tumor and malignant tumor (P 0.010) and between angiomyolipoma and clear cell carcinoma. Conclusion the VTI and VTQ quantitative elastic information of renal neoplasms can be obtained by using the 7% ARFI technique, and the diagnostic accuracy is moderate. It has some clinical application value in the diagnosis of renal tumors.
【作者单位】：南昌大学第一附属医院;
【分类号】：R737.11

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