| ObjectiveThe aim of this study was to investigate the differential diagnosis value of ultrasound shear wave elastography(SWE)via evaluating hardness of different renal occupying lesions by SWE and comparing the differences of shear wave velocity(SWV)between those lesions.Materials and methodsA total of 48 patients with renal occupying lesions were detected by two-dimensional gray-scale ultrasound,colour Doppler flow imaging(CDFI),and shear wave elastography.The data of images,lesion size,morphology,borderline,and internal echo were obtained.Meanwhile,the blood flow distributions of lesions were evaluated by CDFI and the SWV of these lesions and relative normal renal cortex were measured by SWE.For further diagnosis,all patients were examined by enhanced CT and MRI again.Finally,45 patients underwent renal biopsy or operation and post-operative pathology.These 45 patients were divided into four groups: normal renal cortex group of affected side,clear cell carcinoma group,renal angiomyolipoma group,space-occupying lesion of the renal pelvis group.The diagnosis value of SWE via drawing receiver operating characteristic curve(ROC)and calculating the area under curve were evaluated.The data was statistically analysed,P<0.05 was considered to indicate a statistically significant difference.ResultsOf all 48 patients,3 patients had not obtained a final pathological diagnosis because of lacking of renal biopsy or surgical resection.The remaining 45 patients underwent renal biopsy or surgery to obtain pathological diagnosis results,including 27 cases of malignant mass,including 20 cases of clear cell carcinoma,6 cases of renal pelvis epithelial neoplasms,1 case of chromophobe cell carcinoma;All 18 benign tumors were diagnosed as renal angiomyolipoma.There was a significant statistical difference of SWV value between normal renal cortex group of affected side and the other three groups(F= 14.035,P<0.001).The SWV value of normal renal cortex group of affected side(3.04± 0.73m/s)was significantly increased compared with the clear cell carcinoma group(2.34± 0.41m/s),renal angiomyolipoma group(2.03±0.61m/s)and space-occupying lesion of the renal pelvis group(2.26±0.42m/s).The differences of SWV between affected side normal renal cortex group and clear cell carcinoma group,renal angiomyolipoma group,or space-occupying lesion of the renal pelvis group were considered to be statistically significant(P=0.000,P=0.000,P= 0.009).However,there were no statistically significance in the differences of SWV between clear cell carcinoma group and renal angiomyolipoma group(P=0.085),renal angiomyolipoma group and space-occupying lesion of the renal pelvis group(P=0.351),space-occupying lesion of the renal pelvis group and clear cell carcinoma group(P=0.543),with an area under curve of 0.664,0.630,and 0.583.The optimum differential diagnosis truncation value of SWV between normal renal cortex group of affected side and clear cell carcinoma,renal angiomyolipoma,or space-occupying lesion of the renal pelvis were 2.54m/s,2.34m/s,and 2.26m/s,and the AUC were0.804,0.859,and 0.833,while the specificity and sensitivity were 70%,72.2%,66.7% and75.6%,84.4%,86.7% respectively.ConclusionsThere was a statistical difference between the SWV values of the affected side the normal renal cortex and renal occupying lesions.The SWV value of the affected side relative to the normal renal cortex was higher than that of the renal occupying lesion.However,there was no significant difference in SWV values between benign and malignant renal occupying lesions.SWE technology can quantitatively provide elastic information on renal occupying lesions.Although it does not provide a definitive differential diagnosis of the nature of renal occupying lesions,it can assist conventional two-dimensional gray-scale ultrasound and color Doppler flow imaging in the identification of renal occupying lesions and common renal morphological abnormalities,which makes SWE valuable for clinical applications. |
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