| Background: Renal occupied lesions include renal tumor (renal cell carcinoma, renal pelvic carcinoma, metastatic carcinoma), renal angiomyolipoma, renal cysts. New ultrasound contrast agent and contrast-enhanced ultrasound technology provide a powerful tool for clinical non-invasive evaluation of tumor blood vessels, to a large extent made up of deficiencies of color Doppler and power Doppler. SonoVue is the new second-generation ultrasound contrast agent. SonoVue microbubbles whose membrane consists of phospholipids are filled with sulfur hexafluoride (SF6). The diameter is smaller than red blood cell, with a good stability in the blood. The contrast-enhanced ultrasound using very low transmit power and mechanical index hardly destruct microbubbles which generates echo as a scatterer in the blood. The tumor blood perfusion can be better observed with contrast-enhanced ultrasound. At present, contrast-enhanced ultrasound has been widely used in the differential diagnosis of liver lesions. It will be applied to the renal lesions the differential diagnosis which has become a research hotspot.Objective: To explore the ultrasound enhancement pattern of renal occupied lesions of the different pathological types; to investigate the hemodynamic characteristics of renal occupied lesions combined with QontraXt software; to provide the basis for diagnosis of renal occupied lesions using contrast-enhanced ultrasound.Methods: Through injecting SonoVue via peripheral vein, 33 cases of patients with renal occupied lesions underwent contrast-enhanced ultrasound examination. Simple renal cysts and renal column hypertrophy confirmed by CT and clinical diagnosis, the others were confirmed by pathologically. The variation rules of perfusion and echo after bolus injection of SonoVue were observed. Quantitative analysis on 33 renal occupied lesions and their normal cortex by using QontraXt software automatically created time-intensity curve. The curve by fitting gama offered the perfusion parameters: the peak of the signal intensity, the time-to-peak, the sharpness of time-intensity curve, the area under the curve. The changes of quantified parameters of renal lesions and normal cortex of renal of themselves were compared and analysed.Results: (1) Most of the malignant renal lesions enhanced at the same time or fast comparing with the renal corext, the degree of contrast enhancment were identical with the renal corext or higher than the renal corext; Cystic renal cell carcinoma the solid part of lesions and the uneven thickness wall enhanced obviously. (2) Many renal angiomyolipomas presented with delayed enhancment and showed lower enhancement comparing with the renal corext, others enhanced at the same time and the degree of contrast enhancment were identical with the renal corext or higher than the renal corext; renal column hypertrophy washed in and washed out at the same time comparing with the renal corext of themselves; renal juxtaglomerular cell carcinoma enhanced at the same time comparing with the renal corext and showed lower enhancement, then the contrast media washed out quickly. There were no contrast media washing in the simple renal cysts. (3) The peak of the signal intensity and area under the curve in the malignant lesions were higher than the normal renal cortex of themselves, and the difference has statistical significance. The difference on the peak of the signal intensity, the time-to-peak, the sharpness of time-intensity curve and the area under the curve within the benign lesions and the normal renal cortex of themselves has no statistical significance.Conclusion: (1) The enhancement pattern of renal occupied lesions can provide a basis to identify the nature of lesions. (2) The contrast-enhanced ultrasound combined with time-intensity curve can analyse hemodynamic characteristics of renal lesions more objectively and accurately. It can provide informations to the differential diagnosis of renal occupied lesions using contrast-enhanced ultrasound.
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