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目的:探讨超声造影(CEUS)在肾细胞癌(RCC)与肾血管平滑肌脂肪瘤(RAML)鉴别诊断中的价值。方法:回顾性分析经手术病理证实的53例RCC患者和17例RAML患者的二维灰阶超声、彩色多普勒血流显像(CDFI)和CEUS特征。结果:RCC的二维灰阶超声特征以低回声为主,RAML则以高回声为主(P<0.01),但两者的病灶长径、边界、形态和回声均匀性间差异均无统计学意义(P>0.05);RCC的CDFI检查分级以Ⅱ~Ⅲ级为主,而RAML以0~Ⅱ级为主,但两者间差异尚无统计学意义(P>0.05);CEUS特征比较,RCC组与RAML组间患者病灶检查所显示的灌注程度、灌注均匀性和有无环状灌注的差异有统计学意义(P<0.01)。结论:CEUS在RCC与RAML的鉴别诊断中具有重要的临床价值。
Objective: To investigate the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of renal cell carcinoma (RCC) and renal angiomyolipoma (RAML). Methods: Two-dimensional gray-scale sonography, color Doppler flow imaging (CDFI) and CEUS features of 53 RCC patients and 17 RAML patients confirmed by surgery and pathology were retrospectively analyzed. Results: The features of two-dimensional gray scale ultrasound in RCC were mainly low hypoechoicity and RAML were mainly hyperechoic (P <0.01). However, there was no significant difference in the long diameter, boundary, morphology and echo homogeneity between the two groups (P> 0.05). There was no significant difference between the two groups (P> 0.05). The comparison of CEUS features showed that there was no significant difference between the two groups (P> 0.05) The difference of perfusion degree, perfusion uniformity and presence or absence of annular perfusion between the RCC group and the RAML group was statistically significant (P <0.01). Conclusion: CEUS has important clinical value in the differential diagnosis between RCC and RAML.