摘要
目的探讨CEUS应用Bosniak分级诊断肾囊性病灶的价值,并与增强CT比较。方法收集同期接受CEUS和增强CT检查的52例患者共68个肾囊性病灶,观察病灶的形态、边壁、分隔、实性结节及血流灌注情况,评价2种方法分级诊断肾囊性病灶的价值。结果良性组中,25个病灶(25/31,80.65%)CEUS和增强CT均表现为单房或多房囊性病灶,内无分隔或伴纤细分隔,分隔无强化或轻度强化,仅3个病灶(3/31,9.68%)表现为多房囊性病灶伴多个实性结节,2个病灶(2/31,6.45%)表现为花瓣样增强,分隔不规则增厚,1个病灶(1/31,3.23%)表现为网状增强;恶性组中,32个病灶(32/37,86.49%)CEUS和增强CT均表现为多房囊性病灶伴多个实性结节或不规则实性增强区,4个病灶(4/37,10.81%)表现为分隔较厚的多房性囊性病灶,1个病灶(1/37,2.70%)表现为边壁不规则增厚的单房囊性病灶;以Ⅳ级为诊断标准,CEUS和增强CT诊断囊性肾癌的敏感度、特异度、准确率分别为67.57%和70.27%,93.55%和96.77%,79.41%和82.35%。以Ⅲ级及以上为诊断标准,CEUS和增强CT诊断囊性肾癌的敏感度、特异度、准确率分别为97.30%和100%,74.19%和80.65%,86.76%和91.18%。分隔数目≥3条及分隔厚度≥1.75mm可作为诊断肾囊性病灶良恶性的最佳诊断界值。结论 CEUS结合Bosniak标准鉴别诊断肾囊性病灶的良恶性具有较高的价值。
Objective To assess the value of CEUS in the diagnosis of renal cystic lesions according to the Bosniak criteria,in comparison with enhanced CT.Methods Fifty-two patients with 68 cystic renal lesions were included.The ultrasound and CT findings of all lesions,including morphology,walls,septa,solid nodules and blood perfusion,were analyzed.The diagnostic value of CEUS and CT was evaluated.Results In benign group,twenty-five benign cystic lesions（25/31,80.65%）showed thin wall,without or with thin septa,no or mild enhancement in CEUS and enhanced CT,three lesions（3/31,9.68%）presented cystic lesions with multiple septa and solid nodules,two lesions（2/31,6.45%）showed petal-like enhancement with irregular thickening wall,one lesion（1/31,3.23%）performed mesh-ehancement.In malignant group,thirty-two malignant lesions（32/37,86.49%）showed multi-septa cystic lesions with multiple solid nodules or irregular solid reinforced area,4lesions（4/37,10.81%）showed thicker and multiple septa cystic lesion,one lesion（1/37,2.70%）showed irregular thickening of the wall without septa.The sensitivity,specificity and accuracy of CEUS and enhanced CT for renal cystic lesion were 67.57% and 70.27%,93.55% and 96.77%,79.41% and 82.35% according to Bosniak Ⅳfor malignant diagnostic criteria,and were 97.30% and 100%,74.19% and 80.65%,86.76% and 91.18%according to≥BosniakⅢfor malignant diagnostic criteria.The number of septa and the number of septa≥3and thickness of wall≥1.75 mm could be recognized the cut-off value of renal cystic lesions diagnosis.Conclusion The value of CEUS using Bosniak criteria is high in the differential diagnosis of renal cystic lesions.
出处
《中国医学影像技术》
CSCD
北大核心
2014年第12期1888-1892,共5页
Chinese Journal of Medical Imaging Technology
基金
新疆维吾尔自治区自然科学基金(2011211B36)
关键词
超声造影
囊性肾癌
体层摄影术
X线计算机
Contrast-enhanced ultrasonography
Cystic renal cell carcinoma
Tomography
X-ray computed
