声触诊组织定量技术在肾肿瘤诊断中的应用价值

摘要

目的 探讨声触诊组织定量(virtual touch tissue quantification,VTQ)技术在肾肿瘤诊断中的应用价值.方法 120例患者共120个肾肿瘤行VTQ检查.全部病例均经手术及病理证实.检查时分别将感兴趣区置于肿瘤内及肾皮质内,测量剪切波速度(shear wave velocity,SWV)并记录,分别比较SWV值和SWV比值(肿瘤SWV/肾皮质SWV).结果 病理证实良性肾肿瘤24个,其中血管平滑肌脂肪瘤21个,中胚层肾瘤2个,嗜酸细胞型腺瘤1个.恶性肾肿瘤96个,其中透明细胞肾癌78个,乳头状肾癌5个,嫌色细胞肾癌7个,肾尿路上皮癌4个,间叶源性恶性肿瘤及肾母细胞瘤各1个.良性肿瘤与对照肾皮质SWV差异有统计学意义,恶性肿瘤与良性肿瘤之间以及透明细胞肾癌与血管平滑肌脂肪瘤之间SWV比值差异有统计学意义.结论 VTQ技术可以提供肾肿瘤的弹性信息,在肾肿瘤的诊断中有一定应用价值.%Objective To investigate the value of virtual touch tissue quantification in the diagnosis of renal tumors.Methods A total of 120 kidney tumors in 120 consecutive patients were assessed in this study.All tumors were proved by operation and tpathologic findings.VTQ was employed for the measurement of tissue stiffness of kidney tumors.For each lesion,the size,echogenicity,location and margin at baseline grey-scale US were observed and a clear scanning plane including the tumor and surrounding kidney cortex was selected.The VTQ-region of interest were placed both in the tumors and their surrounding cortex.Shear wave velocity(SWV) of the tumors and renal cortex were measured and compared between benign and malignant tumors.Results There were 24 benign kidney tumors and 96 malignant ones.The benign diagnoses included 21 cases of angiomyolipoma,2 cases of mesoblastic nephroma and 1 case of oxyphilic adenoma.The malignant ones included 78 cases of clear renal cell carcinoma,5 cases of papillary renal cell carcinoma,7 cases of chromophobe cell renal cell carcinoma,4 cases of urothelial cancer,1 case of mesenchymal malignancy and 1 case of nephroblastoma.Differences of SWV values between benign tumors and their surrounding cortex were statistically significant (P =0.002).However,no significant difference was found for SWV values between malignant tumors and their surrounding cortex,or between malignant tumors and benign ones (P ＞0.05).For the ratio of SWV values between tumors and their surrounding cortex (tumor SWV/cortex SWV),significant difference was found between benign and malignant ones (P =0.(011) and between clear renal cell carcinoma and angiomyolipoma respectively(P =0.005).Conclusions VTQ can provide the elasticity information of renal lesions and be useful for the diagnosis of renal tumors.