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目的探讨超声造影对不同大小的无症状的肾实性结节的良恶性鉴别诊断价值。方法 74例腹部超声检查发现的无症状肾实性结节患者,结节大小(3.44±1.86)cm,分为≤3cm组和>3cm组,分析各组良恶性超声造影图像特点。结果≤3cm组结节33例,其中肾癌22例;>3cm组结节41例,其中肾癌27例。部分良恶性结节造影图像有交叉表现,以环状增强和高/等增强为诊断条件,超声造影对≤3cm肾癌诊断的特异度和阳性预测值为81.8%、86.7%。以快/同进、高/等增强、环状增强和非均匀增强为诊断条件,超声造影对>3cm肾癌诊断的特异度和阳性预测值为94.1%、92.9%。结论超声造影对无症状的肾实性结节鉴别诊断具有重要价值。
Objective To investigate the differential diagnosis of benign and malignant ascites of different sizes of renal solid nodules by contrast-enhanced ultrasound. Methods Totally 74 patients with asymptomatic nephrotic nodules were examined by abdominal ultrasonography. The nodule size (3.44 ± 1.86) cm was divided into groups of ≤3 cm and> 3 cm. The characteristics of benign and malignant contrast-enhanced ultrasound images in each group were analyzed. Results ≤3cm group of 33 cases of nodules, including renal cell carcinoma in 22 cases;> 3cm group nodules in 41 cases, of which 27 cases of renal cell carcinoma. Some benign and malignant nodules have cross-sectional radiographic images. With ring enhancement and / or enhancement as diagnostic criteria, the specificity and positive predictive value of contrast-enhanced ultrasound in the diagnosis of ≤3 cm renal cell carcinoma were 81.8% and 86.7%, respectively. The specificity and positive predictive value of CEUS for the diagnosis of> 3cm renal carcinoma were 94.1% and 92.9% respectively, with fast / advanced, high / equal enhancement, annular enhancement and non-uniform enhancement as diagnostic criteria. Conclusion Contrast-enhanced ultrasound in the diagnosis of ascites renal solid nodules is of great value.