The Feature Analysis Of Contrast-Enhanced Ultrasonography In Clear Cell Renal Cell Carcinoma

Purpuse:1.With the study of contrast-enhanced ultrasonography(CEUS)in the qualitative diagnosis of clear cell renal cell carcinoma(ccRCC)2.The time-intensity curve analysis software was used to quantitatively analyze the variation characteristics of ccRCC on the time-intensity curve.Methods:A total of 47 patients with clear cell renal cell carcinoma and non-clear cell renal cell carcinoma were enrolled in our hospital from January 2017 to December 2018,which were divided into 34 cases of clear cell renal cell carcinoma and 13 cases of non-clear cell renal cell carcinoma according to the pathological gold standard;Find out the stored images of all tumors in the process of contrast-enhanced ultrasonography,observe and analyze its perfusion mode,inclouding enhancement intensity,enhancement uniformity,pseudocapsule sign,enhancement mode andperfusion pattern;Analyze the dynamic process of the stored CEUS with CHI-Q software,after the software automatically draw the time-intensity curve of the selected ROI,analyze and record the arrival time(AT),the time to peak(TTP)and peak intensity(PI).Statistical analysis was performed.Results:34 cases of ccRCC showed high enhancement(58.82%),inhomogeneous enhancement(67.65%),pseudocapsule(55.88%),diffuse enhancement(85.29%),and fast forward and fast retreat(64.71%);13 cases of non-ccRCC showed low enhancement(69.23%),homogeneous enhancement(69.23%),no pseudocapsule(61.54%),centripetal enhancement(45.15%)and eccentric enhancement and diffuse enhancement(53.85%),�fast forward and slow back�(46.15%)and "slow forward and slow back"(23.08%).The distribution of enhancement intensity,enhancement uniformity,pseudocapsule sign,enhancement mode andperfusion pattern of ccRCC and non-ccRCC were significantly different,P<0.05,which was statistically significant.The distribution of ccRCC and non-ccRCC in the pseudocapsule sign,P=0.285>0.05,which was not statistically significant.The mean values of AT for ccRCC and non-ccRCC were(14.24�1.89)s and(15.10�1.44)s,respectively,and the mean values of TTP were(20.70�1.56)s and(22.10�1.51)s,respectively.The average value of PI was(187.64�7.13)dB and(172.05�10.51)dB.Comparion of AT,TTP and PI between ccRCC and non-ccRCC,there was no significant difference on the values of AT between ccRCC and non-ccRCC,P=0.144>0.05,indicating that no obvious difference was found between ccRCC and non-ccRCC,that was,it was not statistically significant;The difference was obvious between ccRCC and non-ccRCC on the values of TTP,P=0.008<0.05,and the TTP value of ccRCC was lower than that of non-ccRCC,which was statistically significant;The difference was obvious between ccRCC and non-ccRCC on the values of PI,P<0.001,and the PI value of ccRCC was significantly higher than that of non-ccRCC,and the difference was significant.The Receiver Operating Characteristic curve(ROC)was plotted according to the TTP,and the results showed that when 22.8 was taken as the critical value,the diagnostic accuracy of ccRCC was the highest,with a sensitivity of 97.1%,a specificity of 46.2%,and an areaunder curve(AUC)of 0.729.According to the ROC curvedrawn by PI,the results showed that when the critical value was 173.3,the diagnostic accuracy of ccRCC was the hightest,with a sensitivity of 94%,a specificity of 69% and an AUC of 0.898.The sensitivity of TTP and PI was higher,but the AUC and specificity of PI were higher than TTP,so the value of PI in the diagnosis of ccRCC was higher.Conclusion:1.In the qualitative analysis of CEUS,the degree of enhancement,uniformity of enhancement,enhancement mode,and perfusion mode are conducive to thediagnosis of ccRCC.2.In the quantitative analysis of CEUS,according to PI to diagnosis ccRCC is higher.3.In the process of diagnosis,if combined with the qualitative analysis and quantitative analysis of CEUS,we can improve the efficiency of diagnosis ccRCC.