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目的评价超声造影鉴别良恶性肾囊性病变的准确性,探讨超声造影结合Bosniak标准分级诊断肾囊性病变的可行性。资料与方法对30例患者的36个肾囊性病灶进行超声造影,分析良恶性肾囊性病变的超声造影征象;按照Bosniak标准对超声造影的表现进行分级诊断,计算其敏感性、特异性、诊断符合率、阳性预测值、阳性似然比、Kappa值及验后概率,分析该方法分级诊断肾囊性病变的准确性。结果超声造影可显示常规超声不能发现的囊内分隔及实性结构。超声造影结合Bosniak标准诊断肾囊性病变的敏感性、特异性、诊断符合率、阳性预测值、阳性似然比分别为92.9%、90.9%、94.8%、86.7%、10.2,Kappa=0.83;应用超声造影结合Bosniak标准可提高肾囊性病变良恶性诊断的验后概率。结论超声造影结合Bosniak标准可以提高鉴别诊断肾囊性病变良恶性的准确性。
Objective To evaluate the accuracy of contrast-enhanced ultrasound in the differential diagnosis of benign and malignant renal cystic lesions and to explore the feasibility of ultrasound contrast combined with Bosniak standard classification in the diagnosis of renal cystic lesions. Materials and Methods Thirty-six cases of renal cystic lesions in 30 patients underwent contrast-enhanced ultrasonography to analyze the echocardiographic signs of benign and malignant renal cystic lesions. According to the Bosniak standard, the contrast-enhanced ultrasound findings were graded and the sensitivity, specificity, Diagnosis coincidence rate, positive predictive value, positive likelihood ratio, Kappa value and post-test probability, the accuracy of this method for the classification of renal cystic lesions. Results Contrast ultrasound showed intracapsular and solid structures that could not be detected by conventional ultrasound. The sensitivity, specificity, diagnostic coincidence rate, positive predictive value and positive likelihood ratio of contrast-enhanced ultrasound and Bosniak in the diagnosis of renal cystic lesions were 92.9%, 90.9%, 94.8%, 86.7%, 10.2 and Kappa = 0.83, respectively. CEUS combined with Bosniak criteria improves the posterior probability of benign and malignant renal cystic lesions. Conclusions CEUS combined with Bosniak standard can improve the accuracy of differential diagnosis of benign and malignant renal cystic lesions.