The Clinial Research Of Contrast-enhanced Ultrasound Among The Value Of Characteristic Of Blood Stream Perfusion In Renal And Bladder Occupied Lesions

Study background: Renal and bladder tumors are the common tumors in urinary system. The incidence rates of Renal and bladder cancers are increased year by year. They had clinical symptoms early and poor prognosis.It is important that diagnosis and treatment early and had important significance on differential diagnosis of renal and bladder benign and malignant tumors.With the rapid development of technique and new agentsof Contrast-enhanced ultrasound,contrast-enhanced ultrasound had acknowledged value in differential diagnosis of hepatic occupied lesions,however the application reports are relatively less on renal and bladder diseases. We can observed and analyzed the characteristics of renal and bladder occupied lesions in CEUS,and summarized change of ultrasound contrast.It cound improve the lever of diagnosis and differential diagnosis of renal and bladder occupied lesions.Objective: To evaluate the clinical application of Contrast-enhanced ultrasonography(CE US) in Renal and Bladder occupied lesions through observing change of perfusion dynamic enhanced and echo,summarizing trait of ultrasound contrast inRenal and Bladder occupied lesions.Material and Method:1. 28 Patients with Renal and Bladder occupied lesions(31 focuses) were examined by ultrasoound,observing focus of size, amount,echo and blood stream, registering correlation parameter, then concluding principial diagnosis.2. 28 Patients with Contrast-enhanced ultrasonography, sequence observing change process and trait of contrast media , summarizing focus trait of perfusion style and rule. 12 Patients with CECT in 18 cases Renal occupied lesions, ,read and analyze the trait of CT images, then make a conclusion.3. 28 Patients with Renal and Bladder occupied lesions, compared with the sensitivity, specificity and accuracy of ultrasound,CEUS and CECT and calculated diagnostic accuracy comparing with pathology ,then analyze statistically and make a conclusion.Results:1.Ultrasound(1) Renal occupied lesions: The echo of renal malignant tumor is multiformity, no specificity, low echo and commingled echo marked occupied. The blood stream are multiformity,give priority to rich flow. The overall sonographic diagnostic accuracy of renal tumors compared with pathology was 77.8%(14/18). The sensitivity, specificity and accuracy of ultrasound in the diagnosis of renal tumors were 77.8%(7/9), 77.8%(7/9), 77.8%(14/18).(2) Bladder occupied lesions: The bladder malignant tumors are high echo and rich or unrich flow marked occupied. The overall sonographic diagnostic accuracy of bladder tumors compared with pathology was 100%(13/13).2. Contrast-enhanced Ultrasound(1) Renal occupied lesions: the contrast-enhanced imaging feature of renal cell carcinomas are multiformity. It was different in time of start-enhancing and start- expurgation and intensio.3 cases revealed wash-in contemporarily and 6 cases revealed wash- in quickly in time of start-enh ancing.In time of start-expurgating, 3 cases showed wash-out quickly, 3cases revealed wash-out contemporarily,3 cases showed wash-out slowly,6 cases revealed a higher contrast enhancement and 3 cases revealed a even contrast enhancement in enhancing intension; 4 cases with renal cyst s,outline had more clear and inside had no contrast media washing in and enhancing;3cases with renal angiomyolipomas washed in slowly,washed out slowly and equal or low enhanced ; 2cases with renal columnar hypertrophy were no outline appearance and the same enhancement and ech o as the nomal rena tissue. The sensitivity, specificity and accuracy of contrast-enhanced ultraso und in the diagnosis of renal tumors were 88.9%(8/9), 100%(9/9), 94.4%(17/18).(2)Bladder occupied lesions:12cases in13Patients with bladder cancers washed in quickly,washing out quickly and hyper-enhancement, 1cases were similar with renal cortex,washed in quickly,washing out quickly and hyper-enhancement, The overall diagnostic accuracy of bladder tumors compared with pathology was 100%(13/13).3.CECT results: 2case was renal cyst, 2case was renal angiomyolipoma, 9cases were renal transparent cell carcinoma. The overall diagnostic accuracy of renal tumors compared with pathology was 83.3%(10/12). The sensitivity, specificity and accuracy of CT in the diagnosis of renal tumors were 77.8%(7/9), 100%(3/3), 83.3%(10/12).4.The check rates of renal malignant tumor with Contrast-enhanced Ultrasound were higher than Ultrasound and CECT. The sensitivity ,the accuracy and the specificity of clinical diagnosis efficiency were equal to Ultrasound and CECT.Conclusion: Contrast-enhanced Ultrasound has significant function and clinical application value in the diagnosis of renal and bladder occupied lesions .