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目的:探讨超声造影在小肾癌诊断中的价值,提高小肾癌的诊断和治疗水平。方法:回顾性分析了2005年6月～2007年12月间我院收治的35例小肾癌患者B超、CT、IVP、MRI的影像学特征,并对35例小肾癌患者进行了超声造影检查,将超声造影对小肾癌的诊断与病理检查结果进行对比,与增强CT扫描结果进行对比,以探讨超声造影对小肾癌的诊断价值。结果:B超诊断小肾癌的准确率为82.9%,CT诊断小肾癌的准确率为91.7%,MRI诊断小肾癌的准确率为90.4%。超声造影检查35例小肾癌患者共发现36个病灶(有1例患者为左侧多发)。超声造影诊断小肾癌的灵敏度为97.1%,特异度为100%,阳性预测值为100%,阴性预测值为50%,准确率为97.2%。结论:小肾癌的早期诊断主要依赖B超和CT等影像学检查。B超是筛选小肾癌的首选方法;螺旋增强CT可为小肾癌定性、定位诊断提供重要参考价值。超声造影对小肾癌诊断的灵敏度、特异度、阳性预测值和诊断准确率均较高,对小肾癌的诊断具有较高的价值。
Objective: To investigate the value of contrast-enhanced ultrasound in the diagnosis of small renal cell carcinoma and to improve the diagnosis and treatment of small renal cell carcinoma. Methods: The imaging features of B-ultrasonography, CT, IVP and MRI in 35 patients with small renal cell carcinoma admitted to our hospital from June 2005 to December 2007 were retrospectively analyzed. Twenty-five patients with small renal cell carcinoma underwent ultrasonography Contrast contrast imaging and ultrasonography in the diagnosis of small renal cell carcinoma and pathological examination results, compared with the enhanced CT scan to explore the diagnostic value of contrast-enhanced ultrasound in the diagnosis of small renal cell carcinoma. Results: The diagnostic accuracy of B ultrasound in small renal cell carcinoma was 82.9%, the accuracy of CT in diagnosing small renal cell carcinoma was 91.7%, and the accuracy of MRI in diagnosing small renal cell carcinoma was 90.4%. Thirty-six lesions were found in 35 cases of small renal cell carcinoma (one case was left-sided) with contrast-enhanced ultrasound. The sensitivity and specificity of CEUS in diagnosing small renal cell carcinoma were 97.1%, 100%, 100%, and 50%, respectively, with an accuracy of 97.2%. Conclusion: Early diagnosis of small renal cell carcinoma mainly depends on the imaging examination such as B-mode ultrasonography and CT. B ultrasound is the preferred method of screening small renal cell carcinoma; spiral enhanced CT can provide important reference value for the diagnosis of small renal cell carcinoma and localization. The sensitivity, specificity, positive predictive value and diagnostic accuracy of CEUS in the diagnosis of small renal cell carcinoma are high, and it is of high value in the diagnosis of small renal cell carcinoma.