肾良恶性占位病变超声造影误诊分析

目的 分析肾良恶性占位病变的超声造影误诊原因,提高对超声造影的认识水平.方法 回顾性分析经超声造影检查并与手术或穿刺病理结果对照的285例肾占位性病变中,与病理结果对照不符的22例的超声造影表现,分析误诊原因.结果 超声造影对肾良恶性病变的确诊率92.28%(263/285),误诊率7.72%(22/285).9例病理证实为肾血管平滑肌脂肪瘤.均误诊为肾癌,超声造影示5例"快进快出",4例"快进慢出".7例病理证实为肾癌,其中5例误诊为肾血管平滑肌脂肪瘤,造影示4例"快进慢出",1例"同进同出";2例误诊为囊肿,造影示肿块内未见造影剂进入.4例病理证实为肾盂癌,误诊为血肿,造影示肾盂内未见造影剂进入.2例病理证实为炎性假瘤,误诊为肾癌,造影示"快进慢出".结论 超声造影对肾良恶性占位病变诊断符合率高,分析其误诊原因有利于进一步提高对超声造影的认识水平,减少误诊.

Misdiagnosis analysis of renal benign and malignant tumors with contrast-enhanced ultrasound

Objective To analyze the misdiagnosis reasons in renal tumors with contrast-enhanced ultrasound (CEUS) and to improve cognition on CEUS. Methods Two-hundred and eighty-five cases were compared with pathology, the images in 22 cases misdiagnosed on CEUS were reviewed retrospectively and the reasons were analyzed. Results The diagnosis accuracy and misdiagnosis rate of CEUS were 92. 28 % (263/285) and 7. 72%(22/285), respectively. In these 22 cases, 9 cases misdiagnosed as renal cell carcinoma (RCC) were conformed by pathology as renal angiomyolipoma(RAMD), showed 5 cases "fast wash-in and fast wash-out", 4 cases "fast wash-in and slowly wash-out". Seven cases were conformed as RCC, in which 5 were misdiagnosed as RAML, showed 4 cases "fast wash-in and slowly wash-out", 1 cases "simultaneously wash-in and simultaneously wash-out", and 2 were misdiagnosed as renal cyst with no enhancement founded. Four cases misdiagnosed as hematoma were conformed as pyelo-carcinoma, with no enhancement founded in renal pelvis. The remaining 2 cases misdiagnosed as inflammatory pseudotumor were conformed as RCC, showed "fast wash-in and slowly wash-out". Conclusions With the high diagnosis accuracy,CEUS is an important method in diagnosis of renal tumors. Analyzing the misdiagnosed reasons may improve the cognition on CEUS and decrease the misdiagnosis.