摘要
目的探讨增强超声(CEUS)对囊性肾肿块的评估价值。方法选取2019年6月至2020年12月期间在上海中医药大学附属曙光医院行增强CT(CECT)扫描并被诊断为囊性肾肿块的80例患者进行前瞻性CEUS评估,按照2019版Bosniak分级进行评价。基于最终组织病理学和临床随访的结果,绘制受试者工作特征(ROC)曲线评估CEUS和CECT对良恶性囊性肾肿块的诊断效能,采用加权Kappa评估CECT和CEUS对良恶性囊性肾肿块诊断的内部一致性以及两种影像模式之间的一致性。结果80例患者的囊性肾肿块大小中位数为3.0cm,其中46例为良性病变,34例为恶性病变。CEUS对其敏感性和阴性预测值均达到100%,而特异性和阳性预测值均为73.9%;CECT对其敏感性和阴性预测值分别为88.2%和83.3%,特异性和阳性预测值分别为87%和90.9%。两种成像模式对良恶性病变诊断的内部一致性表现出相似的准确性(CEUS和CECT的kappa值分别为0.71和0.75)。在60例(占75%)患者中,CEUS和CECT对良恶性病变诊断之间的一致性达到了良好一致性(kappa=0.74)。结论CEUS与CECT在评估囊性肾肿块方面的准确性相当。CEUS可作为筛查工具用于排除复杂囊性肾肿块的存在,从而避免肾毒性对比剂和电离辐射的暴露。
Objective To investigate the efficacy of contrast-enhanced ultrasound(CEUS)in evaluating cystic renal masses.Methods A prospective study was conducted on 80 patients diagnosed with cystic renal masses through contrast-enhanced computed tomography(CECT)at Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from June 2019 to December 2020.The assessment was performed using CEUS according to the 2019 Bosniak classification.Based on the final histopathological and clinical follow-up results,receiver operating characteristic(ROC)curves were drawn to evaluate the diagnostic performance of CEUS and CECT in differentiating between benign and malignant cystic renal masses.Weighted Kappa statistics were employed to assess the internal consistency of CECT and CEUS diagnoses,as well as the concordance between the two imaging modalities.Results The median size of the cystic renal masses in the study cohort was 3.0 cm.Of the 80 patients,46 had benign lesions,and 34 had malignant lesions.CEUS exhibited a sensitivity and negative predictive value of 100%,while its specificity and positive predictive value were both 73.9%.In comparison,CECT had a sensitivity of 88.2%,a negative predictive value of 83.3%,a specificity of 87%,and a positive predictive value of 90.9%.The two methods demonstrated similar internal consistency in diagnosing benign and malignant lesions,with kappa values of 0.71 for CEUS and 0.75 for CECT.Additionally,there was substantial concordance between CEUS and CECT in diagnosing the nature of the lesions in 60 patients(75%),with a kappa value of 0.74.Conclusion CEUS and CECT have comparable accuracy in evaluating cystic renal masses.CEUS can be used as a screening tool to exclude the presence of complex cystic renal masses,thereby avoiding exposure to nephrotoxic contrast agents and ionizing radiation.
作者
彭春红
李祖玲
郑一君
吴凡
李胜
陈庆
郭佳
PENG Chun-hong;LI Zu-ling;ZHENG Yi-jun;WU Fan;LI Sheng;CHEN Qing;GUO Jia(Department of Ultrasound,Shuguang Hospital Affiliated to Shanghai University of Chinese Traditional Medicine,Shanghai 201203,CHINA;Department of Ultrasound,Logistics Support Unit 900th Hospital,Fuzhou 350002,Fujian,CHINA)
出处
《海南医学》
CAS
2024年第16期2362-2365,共4页
Hainan Medical Journal
关键词
囊性肾肿块
增强超声
增强CT
Bosniak分类
评估
Cystic renal mass
Contrast-enhanced ultrasound
Contrast-enhanced CT
Bosniak classification
Assessment
