本文選題：超聲檢查 + 聲輻射力脈沖��； 參考：《實用醫(yī)學雜志》2014年15期

【摘要】：目的:探討聲輻射力脈沖(acoustic radiation force impulse,ARFI)技術在腎腫瘤診斷中的應用價值。方法:對110例患者共110個腎腫瘤行聲觸診組織成像(virtual touch tissue imaging,VTI)及聲觸診組織量化(virtual touch tissue quantification,VTQ)檢查,獲取其VTI圖像及腎腫瘤、患側腎皮質、對側腎皮質的剪切波速度(shear wave velocity,SWV)值,全部病例均經手術后病理證實。結果:病理證實良性腎腫瘤20個(血管平滑肌脂肪瘤18個,嗜酸細胞腺瘤2個),惡性腫瘤90個(透明細胞癌72個,嫌色細胞癌8個,乳頭狀癌6個,囊性腎癌4個)。VTI診斷腎惡性腫瘤的敏感度、特異性、陽性預測值、陰性預測值、準確率、Youden指數(shù)及ROC曲線下面積分別為71.11%(64/90)、70.00%(14/20)、91.43%(64/70)、35.00%(14/40)、70.91%(78/110)、41.11%、0.706。VTQ診斷腎惡性腫瘤的敏感度、特異性、Youden指數(shù)、ROC曲線下面積及最佳截斷點值分別為66.70%、90.00%、56.70%、0.748、2.44 m/s。良性腫瘤與同側腎皮質之間(P=0.000)、惡性腫瘤與同側腎皮質之間(P=0.000)、良性腫瘤與惡性腫瘤之間(P=0.013)以及血管平滑肌脂肪瘤與透明細胞癌之間(P=0.022)SWV值差異有統(tǒng)計學意義,良性腫瘤與惡性腫瘤之間(P=0.010)以及血管平滑肌脂肪瘤與透明細胞癌之間(P=0.017)SWV比值差異有統(tǒng)計學意義。結論:ARFI技術可以提供腎腫瘤的VTI定性及VTQ定量的彈性信息,診斷準確度均達到中等,在腎腫瘤的診斷中有一定臨床應用價值。
[Abstract]:Objective: to evaluate the value of acoustic radiation impulse radiation force impulse technique in the diagnosis of renal tumors. Methods: 110 renal tumors were examined by virtual touch tissue imaging (VTI) and acoustic palpation tissue quantitative touch tissue quantification (VTQs). The VTI images and renal tumors were obtained. The shear wave velocities of the affected renal cortex and the contralateral renal cortex were measured. All cases were confirmed by pathology after operation. Results: twenty benign renal tumors (18 angiomyolipoma, 2 eosinophils adenoma, 90 malignant tumors (72 clear cell carcinoma, 8 chromophobe cell carcinoma, 6 papillary carcinoma) were confirmed by pathology. The sensitivity, specificity, positive predictive value, negative predictive value, accurate rate of Youden index and area under the ROC curve of 4 patients with cystic renal cell carcinoma were 71.1164 / 90 and 70.0014 / 20 respectively. The sensitivity of diagnosis of renal malignancy was 91.43 / 64 / 70 / 40 / 70.9178 / 11 / 0.706.VTQ, respectively. The area under the ROC curve and the optimum cut-off point were 66.70 and 90.00m / s, 56.70 and 0.7482.44 m / s, respectively. There were significant differences in SWV between benign tumor and ipsilateral renal cortex, between malignant tumor and ipsilateral renal cortex, between benign tumor and malignant tumor, and between angiomyolipoma and clear cell carcinoma. There were significant differences in SWV ratio between benign tumor and malignant tumor (P 0.010) and between angiomyolipoma and clear cell carcinoma. Conclusion the VTI and VTQ quantitative elastic information of renal neoplasms can be obtained by using the 7% ARFI technique, and the diagnostic accuracy is moderate. It has some clinical application value in the diagnosis of renal tumors.
【作者單位】： 南昌大學第一附屬醫(yī)院;
【分類號】：R737.11

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