Study On The Application Of Contrast-enhanced Ultrasound In The Diagnosis Of Renal Cystic Occupied Lesions

Purpose: To discuss the characteristics of renal cystic lesions on contrast-enhanced ultrasound, and provide imaging evidences for early diagnosis of cystic renal cell carcinoma. Material and Methods: 35 patients with 38 lesions were chosen from March 2013 to December 2014 at Affiliated Hospital of Qinghai University whom were diagnosed as renal cystic lesions by ultrasound. Observe and record all the patients’ clinical data in detail. First, examined patients by conventional and color Doppler ultrasound to get the best sections of the lesions and record the location、size、cyst wall、internal echo(calcification,solid nodules),then carefully observe the interior blood-flow circumstances of the masses, to make a preliminary diagnosis before angiography. Then switch to the contrast mode. Injected SONOVUE 2.4ml by cubital vein, then 5ml of saline bolus. Observe the progress 3-4mins. Downloaded all the pictures and progresses to be analyzed. Selected the strongest intralesional contrast perfusion region as ROI area, The software automatically draw time-intensity curves to get parameters as time to peak(TP)、peak intensity(PI)、area under the curve(AUC). Results: 1、There were 18 benign cases in 35 patients with 38 lesions. CEUS characteristics mainly performance non-enhanced enhancement and weak enhancement, enhancement patterns of this group displayed “slow Wash-in and fast wash-out” 、“simultaneous wash-in and wash-out” type.The curve was slick, low and flat. 2、There were 20 malignant cases in 35 patients with 38 lesions. CEUS characteristics mainly performance heterogeneous and peripheral enhancement, presented hyper-enhanced significantly in cyst wall, separations and solid nodule, boundary was not clear, enhancement patterns of this group displayed “fast wash-in and slow wash-out” type. The curve of ascending branch was steep, descending branch was flat. 3、35 patients with 38 lesions of CEUS in the diagnosis of the benign and malignant and compared with pathological results. The differences of the peak intensity, peak time, area under the curve and the enhancement patterns and features between benign and malignant tumors had statistical significance(P <0. 05). 4、The accuracy in the diagnosis of renal cystic lesions of benign and malignant are higher with contrast enhanced ultrasound examination than color Doppler ultrasound.Conclusion: Contrast-enhanced ultrasound is expected to become a kind of cystic renal tumors preoperative noninvasive imaging methods, provide an important basis for early diagnosis of cystic renal cell carcinoma.