Abstract：Objective: To investigate the characteristics and differential diagnostic value of conventional ultrasound and contrast-enhanced ultrasound in renal clear cell carcinoma (CCRCC). Methods: A total of 76 patients (CCRCC group) with CCRCC who were treated in our hospital from September 2020 to August 2022 were selected,including Fuhrman classification:48 cases of grade Ⅰ~Ⅱ and 28 cases of grade Ⅲ-Ⅳ.,and 50 patients with renal angiomyolipoma (RAML) who were treated at the same time were selected as the control group (RAML group).The differences between conventional ultrasound and contrast-enhanced ultrasound images of the two groups were compared,and the differences between conventional ultrasound and contrast- enhanced ultrasound images of CCRCC lesions with different Fuhrman grades were analyzed,as well as the diagnostic value of conventional ultrasound combined with contrast-enhanced ultrasound. Results: The diameter of lesions in CCRCC group was (35.54 ± 11.02) mm,which was significantly higher than that in RAML group (P<0.05).The proportion of hypoechoic,rich blood flow,"fast forward" perfusion,high perfusion intensity,uneven perfusion and peripheral annular enhancement in CCRCC group was 81.58%,57.89%,94.74%,93.42%,73.68% and 42.11% respectively,which was significantly higher than that in RAML group (P<0.05).Compared with grade Ⅰ~Ⅱ lesions,the diameter of grade Ⅲ ~Ⅳ lesions in CCRCC group was (41.25±10.03) mm,which was significantly higher (P<0.05).Compared with in grade Ⅰ~Ⅱ lesions,the percentage of peripheral annular enhancement in grade Ⅲ ~ Ⅳ lesions in CCRCC group was 56.25%,which was significantly higher (P<0.05).Compared with conventional ultrasound and contrast-enhanced ultrasound,the sensitivity of conventional ultrasound+ contrast-enhanced ultrasound in the diagnosis of CCRCC was 94.74%,which was significantly higher (P<0.05).The accuracy and negative predictive value of conventional ultrasound+ contrast- enhanced ultrasound in the diagnosis of CCRCC were 86.51% and 90.24%,respectively,which were significantly higher than those of conventional ultrasound (P<0.05).The accuracy of contrast-enhanced ultrasound in the diagnosis of CCRCC was 83.33%,which was significantly higher than that of conventional ultrasound (P<0.05). Conclusion: Compared with RAML,the image features of conventional ultrasound and contrast-enhanced ultrasound of CCRCC are different to some extent,the combination of conventional ultrasound and contrast-enhanced ultrasound has better application value in differential diagnosis of CCRCC.
王磊, 何年安, 叶显俊, 胡蕾, 崔亚云. 肾透明细胞癌的常规超声及超声造影声像图表现特征及鉴别诊断分析[J]. 河北医学, 2023, 29(7): 1120-1125.
WANG Lei, HE Nianan, YE Xianjun, et al. Characteristics and Differential Diagnosis of Conventional Ultrasound and Contrast-enhanced Ultrasound in CCRCC. HeBei Med, 2023, 29(7): 1120-1125.
[1] Han D,Yu Y,Yu N,et al.Prediction models for clear cell renal cell carcinoma ISUP/WHO grade:comparison between CT radiomics and conventional contrast-enhanced CT[J].The British Journal of Radiology,2020,93(1115):e131. [2] Liu Y,Kan Y,Zhang J,et al.Characteristics of contrast-enhanced ultrasound for diagnosis of solid clear cell renal cell carcinomas ≤4 cm:a meta-analysis[J].Cancer Medicine,2021,10(23):8288-8299. [3] Liu H,Cao H,Chen L,et al.The quantitative evaluation of contrast-enhanced ultrasound in the differentiation of small renal cell carcinoma subtypes and angiomyolipoma[J].Journal of Ultrasound in Medicine,2022,12(1):106-118. [4] Oostenbrugge T V,Mulders P.Targeted PET/CT imaging for clear cell renal cell carcinoma with radiolabeled antibodies:recent developments using girentuximab[J].Current Opinion in Urology,2021,31(3):249-254. [5] Sun D,Lu Q,Wei C,et al.Differential diagnosis of <3cm renal tumors by ultrasonography:a rapid,quantitative,elastography self-corrected contrast-enhanced ultrasound imaging mode beyond screening[J].The British Journal of Radiology,2020,93(1112):e974. [6] Guo B,Liu M.Renal cell carcinoma:comparison between variant histology and clear cell carcinoma across All stages and treatment modalities[J].The Journal of urology,2021,205(5):1525-1527. [7] 徐明哲,刘爱连,孙美玉,等.磁共振DWI及DTI在肾透明细胞癌与乏脂性肾血管平滑肌脂肪瘤鉴别中的价值[J].临床放射学杂志,2020,39(1):96-102. [8] Xiang M,FengDu,Dai J,et al.Exploring serum metabolic markers for the discrimination of ccRCC from renal angiomyolipoma by metabolomics[J].Biomarkers in Medicine,2020,14(8):675-682. [9] 郑丽丽,任新平,詹维伟,等.常规超声结合超声造影对肾透明细胞癌与肾血管平滑肌脂肪瘤的鉴别诊断价值[J].第二军医大学学报,2021,42(6):609-616. [10] 李嘉俊,胡祎,程印蓉,等.肾透明细胞癌的超声造影特征研究[J].肿瘤预防与治疗,2020,33(11):874-880. [11] 岑吉,胡豪飞,程媛,等.广西多民族聚居地区单中心肾活检病理资料及民族特点分析[J].成都医学院学报,2021,16(4):482-485,511. [12] 高琼,何蒙娜,蒋天安.肾细胞癌常规超声及超声造影特征[J].中国医学影像技术,2021,37(12):1784-1788.
2023, Vol. 29 
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