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对比增强超声与对比增强 CT 检测和描述肾肿块的对比研究。

A comparative study of contrast-enhanced ultrasound and contrast-enhanced CT for the detection and characterization of renal masses.

机构信息

Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.

Shanghai Key Laboratory of Clinical Geriatric Medicine Shanghai, China.

出版信息

Biosci Trends. 2021 Mar 15;15(1):24-32. doi: 10.5582/bst.2021.01026. Epub 2021 Feb 26.

Abstract

This study aims to compare the value of contrast-enhanced ultrasound (CEUS) and contrast-enhanced CT (CECT) in the differential diagnosis of benign and malignant renal masses. Included in this retrospective study were 143 renal masses in 141 patients using histopathological findings as the gold standard. A comparison was made of the two modalities in image characteristics for their accuracy in the differential diagnosis of renal masses. CEUS and CECT were both used for 39 masses in 37 patients, with 31 (79.5%) being malignant and 8 (20.5%) benign. The differences between the benign and malignant groups in perfusion intensity, perfusion uniformity and entry and exit of the contrast agent were not statistically significant (P > 0.05). However, CEUS could better display the circular perfusion of renal cell carcinoma than CECT (P < 0.05). CECT alone detected 109 masses in 107 patients, with 93 (85.3%) being malignant and 16 (14.7%) benign. CEUS detected 73 masses in 71 patients, with 56 (76.7%) being malignant and 17 (23.3%) benign. No statistically significant differences were observed between CEUS and CECT in the diagnosis of renal cell carcinoma (92.8% vs. 90.3%), with a specificity of 52.9% vs. 31.2%, an accuracy of 83.5% vs. 81.6%, and a positive predictive value of 86.7% vs. 88.4% or a negative predictive value of 69.2% vs. 35.7% (P > 0.05 for all). These results suggested both CEUS and CECT are highly valuable in the differential diagnosis of renal masses, and CEUS can be used as an important supplement for CECT in diagnosis of renal cancer.

摘要

本研究旨在比较超声造影(CEUS)和增强 CT(CECT)在鉴别良恶性肾肿块中的价值。本回顾性研究纳入了 141 例患者的 143 个肾肿块,以组织病理学结果为金标准。比较了两种方法在图像特征方面的准确性,以鉴别肾肿块。CEUS 和 CECT 均用于 37 例患者的 39 个肿块,其中恶性 31 个(79.5%),良性 8 个(20.5%)。良性和恶性组在灌注强度、灌注均匀性和造影剂进出方面的差异无统计学意义(P>0.05)。然而,CEUS 能更好地显示肾细胞癌的环状灌注(P<0.05)。CECT 单独用于 107 例患者的 109 个肿块,其中恶性 93 个(85.3%),良性 16 个(14.7%)。CEUS 单独用于 71 例患者的 73 个肿块,其中恶性 56 个(76.7%),良性 17 个(23.3%)。CEUS 和 CECT 在诊断肾细胞癌方面无统计学差异(92.8% vs. 90.3%),特异性分别为 52.9% vs. 31.2%,准确性分别为 83.5% vs. 81.6%,阳性预测值分别为 86.7% vs. 88.4%,阴性预测值分别为 69.2% vs. 35.7%(均 P>0.05)。这些结果表明,CEUS 和 CECT 在鉴别肾肿块方面均具有很高的价值,CEUS 可作为 CECT 诊断肾癌的重要补充。

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