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目的探讨多房囊性肾瘤(MLCN)和多房囊性肾癌(MCRCC)的超声造影(CEUS)表现,以期提高术前诊断及鉴别诊断的准确度。方法采用回顾性分析经手术病理证实的6例MLCN患者和16例MCRCC患者CEUS表现,对MLCN和MCRCC的部分CEUS表现进行统计学分析。结果6例MLCN和16例MCRCC均表现为肾内单发多房囊性肿块,6例MLCN皮质期均可见增强,囊壁及分隔厚度相对均匀,未见增强实性结节,Bosniak分级主要表现为ⅡF级(2例)和Ⅲ级(4例)。16例MCRCC皮质期亦全部可见增强,囊壁及分隔不均匀增厚伴增强的实性结节8例,Bosniak分级:ⅡF级(2例)、Ⅲ级(6例)、Ⅳ级(8例)。MLCN和MCRCC常规超声表现差异无统计学意义(P>0.05);CEUS表现中,肿瘤囊壁及分隔厚度、有否增强实性结节、增强达峰强度及BosniakⅣ级的差异均有统计学意义(P<0.05)。结论CEUS可对MLCN和MCRCC术前的正确诊断和鉴别诊断提供较多有价值的信息。
Objective To investigate the ultrasonography (CEUS) findings of multilocular cystic nephroma (MLCN) and multilocular cystic renal cell carcinoma (MCRCC) in order to improve the accuracy of preoperative diagnosis and differential diagnosis. Methods The CEUS findings of 6 MLCN patients and 16 MCRCC patients confirmed by surgery and pathology were retrospectively analyzed. The CEUS findings of MLCN and MCRCC were analyzed statistically. Results Six cases of MLCN and 16 cases of MCRCC all showed single polycystic cystic mass in the kidney. The cortical phase of MLCN was found to be enhanced in 6 cases. The thickness of the cyst wall and septum were relatively uniform with no enhancement of solid nodules. The main manifestations of the Bosniak grading ⅡF grade (2 cases) and Ⅲ grade (4 cases). 16 cases of MCRCC also showed enhanced cortical phase, 8 cases of uneven wall and enhanced solid nodules with enhanced solid nodules, Bosniak classification: Ⅱ F grade in 2 cases, Ⅲ grade in 6 cases, Ⅳ grade in 8 cases ). There was no significant difference in routine ultrasound findings between MLCN and MCRCC (P> 0.05). In CEUS, there was significant difference in tumor wall and septum thickness, solid nodules, peak intensity enhancement and Bosniak Ⅳ grade (P <0.05). Conclusion CEUS can provide more valuable information for the correct diagnosis and differential diagnosis of MLCN and MCRCC before operation.