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目的:对比超声造影与实时组织弹性成像联合靶向穿刺活检诊断肾肿瘤的价值。方法:肾肿瘤患者88例,靶向穿刺活检诊断为肾恶性肿瘤(恶性组)60例,肾良性肿瘤(良性组)28例,两组都进行超声造影与实时组织弹性成像诊断与分析。结果:恶性组在增强时间上主要表现为快进快退型,增强强度主要为高强度;而良性组主要为慢进慢退型和低增强。恶性组的应变均值(MEAN)、标准偏差(SD)、复杂度(COMP)、偏度(KURT)和一致性(ASM)与良性组对比差异都有统计学意义(P<0.05)。以穿刺活检病理作为诊断金标准,超声造影诊断肾肿瘤的敏感性与特异性为90.0%和78.6%,而实时组织弹性成像的诊断敏感性与特异性为98.3%和100.0%,实时组织弹性成像的诊断特异性明显高于超声造影(P<0.05)。结论:超声造影诊断肾肿瘤具有很好的影像学特征,实时组织弹性成像参数也能反映肾肿瘤的良恶性情况,其中实时组织弹性成像的诊断特异性更好,有很好的临床应用价值。
OBJECTIVE: To evaluate the value of contrast-enhanced ultrasound and real-time tissue elastography combined with targeted biopsy in the diagnosis of renal tumors. Methods: 88 cases of renal tumor and 60 cases of renal malignant tumor (benign group) and 28 cases of benign renal neoplasm (benign group) were diagnosed by targeted biopsy. Both groups were diagnosed and analyzed by contrast-enhanced ultrasound and real-time tissue elastography. Results: The malignant group mainly showed fast-moving fast-reverse type in enhancing time, the enhanced intensity was mainly high-intensity, while the benign group was slow-slow-slowing and low enhancement. The MEAN, SD, COMP, KURT and ASM in malignant group were significantly different from those in benign group (P <0.05). The sensitivity and specificity of CEUS in the diagnosis of renal tumors were 90.0% and 78.6%, respectively. The diagnostic sensitivities and specificities of real-time tissue elastography were 98.3% and 100.0%. Real-time tissue elastography The diagnostic specificity was significantly higher than that of contrast-enhanced ultrasound (P <0.05). Conclusion: Contrast-enhanced ultrasound imaging of renal tumors has good imaging features, and real-time tissue elastography parameters can also reflect the benign and malignant tumors of kidney neoplasms. The diagnostic specificity of real-time tissue elastography is better and has good clinical value.