CTU、增强MRI和CEUS在肾占位病变定性诊断中准确率的多维度分析

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Multidimensional analysis of accuracy of CTU，contrast-enhanced MRI and CEUS in qualitative diagnosis of renal space-occupying lesions

WU Linjie，YU Ying，BAI Xiaojie，QI Zihao，ZHENG Hang，GUO Zhongqiang

（Department of Urology，Zhongnan Hospital of Wuhan University，Wuhan 430071，China）

ABSTRACT：Objective To compare the diagnostic accuracy of three imaging modalities，inlducing CT urography （CTU），contrast-enhanced MRI （CE-MRI），and contrast-enhanced ultrasound （CEUS） in the qualitative diagnosis of renal space-occupying lesions.Methods A retrospective analysis was performed on 542 patients with renal lesions confirmed by surgical pathology in our hospital during Jan.2019 and May 2024.The diagnostic results of CTU，CE-MRI and CEUS were compared and analyzed based on the patients clinical and pathological data.Results The diagnostic accuracy rate of CTU，CE-MRI and CEUS were 84.50%，83.14% and 86.14%，respectively.For the 161 patients who underwent all three examinations，CEUS was significantly more accurate than CTU （84.16% vs. 77.02%，P=0.018），while there was no significant difference between CTU or CEUS and CE-MRI （79.81%） （P＞0.05）.Further analysis found that for lesions ≤4 cm，the accuracy of the three examinations was as follows：CEUS=CTU 79.55%，CE-MRI 76.14%，with no significant difference （P＞0.05）.However，for lesions >4 cm，CEUS ranked the first，followed by CE-MRI and CTU （89.73% vs. 84.25% vs. 73.97%），and CEUS and CE-MRI were better than CTU （P<0.05）.Additionally，for the diagnosis of clear cell renal carcinoma and benign renal space-occupying lesions，there was no statistically significant difference among the three imaging modalities （P＞0.05），while for the qualitative diagnosis of non-clear cell renal carcinoma，CEUS ranked the first，followed by CE-MRI and CTU （83.87% vs. 74.19% vs. 56.45%），and CE-MRI and CEUS were better than CTU （P<0.05）.Conclusion All of them have important diagnostic value，and the appropriate selection should be based on patients specifc conditions.CEUS and CE-MRI are more accurate in the qualitative diagnosis of renal space-occupying lesions than CTU，especially for large lesions and non-clear cell carcinoma.

KEY WORDS：

computed tomography urography；magnetic resonance imaging；contrast-enhanced ultrasound;renal space-occupying lesions;qualitative diagnosis

摘要：目的 多维度比较分析计算机体层成像尿路造影（CTU）、增强磁共振成像（MRI）及超声造影（CEUS）在肾占位性病变中定性诊断的准确率。（剩余7841字）