摘要
目的探讨超声造影(CEUS)结合Bosniak分级在肾脏囊性病变诊断中的应用价值。方法选取2010年8月至2016年8月在上海交通大学附属第一人民医院确诊的75个肾脏囊性病灶的超声造影声像图特征,并结合Bosniak分级标准对75个病灶进行分类,手术病例以术后病理结果为"金标准",非手术病例临床随访2年以上(超声造影、增强CT等)。采用四格表计算用超声造影结合Bosniak分级标准对是否需要手术判断的准确性、敏感度、特异度、阳性预测值、阴性预测值。采用配对资料的χ2检验对Bosniak阳性诊断率和手术病理结果阳性诊断率进行比较。结果 75个肾脏囊性病灶中,超声造影结合Bosniak分级标准诊断为Ⅰ级2个,Ⅱ级33个,ⅡF级8个,Ⅲ级19个,Ⅳ级13个。超声造影结合Bosniak分级检查阳性率与手术病理检查阳性率,差异无统计学意义(χ^2=0.243,P=0.622)。对是否需要手术治疗的判断的敏感度为85.71%、特异度为95.00%、准确性为90.67%、阳性预测值为93.75%、阴性预测值为88.37%。结论超声造影结合Bosniak分级标准在肾脏囊性病变良恶性鉴别诊断中有较高的应用价值,有助于临床医师制订准确的临床治疗方案。
Objective To assess the value of contrast-enhanced ultrasonography(CEUS)combined with the Bosniak classification system in the diagnosis of renal cystic lesions.Methods Seventyfive patients with renal cystic lesions selected between August 2010 and August 2016 at the Shanghai First People's Hospital of Shanghai Jiaotong University were retrospectively analyzed and categorized by the Bosniak classification system according to the CEUS features,and the results were compared with their clinical follow-up or pathological results after surgery.The sensitivity,specificity,accuracy,positive predictive value(PPV),and negative predictive value(NPV)were calculated to assess its diagnostic performance.Results According to the Bosniak classification system,the lesions were diagnosed as grade I in 2 cases,gradeⅡin 33,gradeⅡF in 8,gradeⅢin 19,and gradeⅣin 13 by CEUS.There was no significant difference(χ^2=0.243,P=0.622)in the positive detection rate between CEUS combined with the Bosniak system and surgical pathology.The sensitivity,specificity,accuracy,PPV,and NPV were 85.71%,95.00%,90.67%,93.75%,and 88.37%,respectively.Conclusions CEUS combined with the Bosniak classification system is of highly value in differentiating benign and malignant renal cystic lesions.Besides,it is useful for accurately formulating the clinical treatment plan.
作者
陈惠莉
杜联芳
蔡应娱
李凡
刘阳
Chen Huili;Du Lianfang;Cai Yingyu;Li Fan;Liu Yang(Department of Ultrasound,Shanghai First People′s Hospital,Shanghai Jiaotong University,Shanghai 200080,China)
出处
《中华医学超声杂志（电子版）》
CSCD
北大核心
2019年第9期697-701,共5页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
肾脏
肾脏囊性病变
超声检查
造影剂
Kidney
Renal cystic lesions
Ultrasonography
Contrast agent
