Comparison Study Of The Diagnosis Of Kidney Tumors Between Color Doppler Ultrasound And Computed Tomography

Objective:(1) to compare color Doppler ultrasound, CT diagnosis of renal tumor sensitivity, accuracy and specificity. (2) to compare both the diagnosis of malignant kidney tumor staging accuracy. (3) to guide clinical selection of effective, economical, non-invasive diagnosis of renal tumors manner.Materials and Methods:Choosing our hospital kidney tumor patients can tolerate surgery in November 2009 to January 2011. Before Surgery,the patients should be completed Color Doppler Flow Imaging (CDFI) and Helical Computed Tomograph (HCT) two kind of inspections. Excluding the following conditions:(1) Imaging diagnosis confirmed in multiple distant metastases, The patient cannot the surgery; (2)completed only CDFI or HCT in one of the two examinations; (3) renal cysts; (4)The same patient, multiple renal tumors which were included in the study selected the largest. The 105 renal tumors of 105 patients were enrolled in this study.105 patients, male 58 cases,47 females, mean age was 47.7 years.We used the color Doppler supersonic diagnostic equipment of HITACHI HV900 and Philips iU22. The probe frequency is of 3.5-5.0MHZ. The patient were taked bends down the decubitus, the side decubitus or the supine decubitus, We usually measured the size of the kidney,observed kidney involucrum continuity, whether there was gathers the system to separate, measured the survey tumor size, Observed kidney vein and vena cava inferior whether there was cancer hitch and retroperitoneal lymph node shifted, and so on. Then detected blood stream distributing situation within and around the tumor by color Doppler flow imaging blood flow technology. According to the internal flow signals of tumor was divided into four levels,Ⅰlevel:less blood type;Ⅱlevel:Star point type;Ⅲlevel:blood-rich;Ⅳlevel:hold the ball type.Measured blood flow resistance indexin (RI) within and around the tumor, sample volume was<2mm, and the angle between Sound beam and the blood vessels was less than 60 degrees, measured three times and averaged.The CT inspection was used 16 screw Philips CT machine inspection. Before the inspection, often did not eat in 8h, before the inspection, 0.5～1h taked orally 3% pan-shade Portugal amine 1000ml fulled gastro-intestinal tract. First the kidney was Scanned, the level thick is 5mm, after the pitch was 1.5, carried on the coronal plane, the sagittal plane and the surface image reconstruction, Multi-dimensional observation of the relationship between lesion and surrounding tissue. The enhancement scanning used the high-pressured injector to pour into 80 ml superior Uygur after the elbow vein obviously, speed 2.5-3.0ml/s, after injecting the contrast agent,30s made the kidney cerebral cortex time enhancement scanning,60s made the kidney essence time scanning, 3min made the renal pelvis time scanning. When scanning the patient holded one's breath under in a calm state.the two test results with surgical pathology results were compared Compared with the two diagnosis kidney tumor rate of the sensitivity,the specificity,the accuracy and both the accuracy which diagnoses by stages at the kidney cancer separately.All data was inputed SPSS 13.0 software, group's comparison used McNemar's test. To P＜0.05 was considered statistically significant. Results:①The 105 patients, pathological diagnosis showed:renal clear cell carcinoma 28 cases,the papillary cell cancer 12 cases, kidney blood vessel smooth muscle adipose tumor (renal hamartoma) 52 cases, renal pelvis transitional cell cancer 7 cases,the Wilms tumor 3 cases, the cystic cell cancer 1 case,the kidney angioma 2 cases.②51 example kidney cancers, used the Robson frame work method, the surgery proved thatⅠtime of 28 examples;Ⅱtime of 15 examples;Ⅲtime of 6 examples;Ⅳtime of 2 examples.②105 cases of kidney tumors,the sensitivity of ultrasound was 86.3%(44/51), specificity was 79.6%(43/54), accuracy was 82.9%(87/105), ultrasound diagnoses the rate of accuracy by stages respectively was:Ⅰtime of 67.9%(19/28),Ⅱtime of 66.7%(10/15),Ⅲtime of 16.7%(1/6),Ⅳtime of 0%(0/2).④105 example renal tumors, the sensitivity, the specificity and the accuracy of CT respectively was 84.3%(43/51),88.9%(48/54) and the 86.7%(91/105),51 example kidney cancers, CT diagnoses the rate of accuracy by stages respectively was:Ⅰtime of 75.0%(21/28),Ⅱtime of 80.0%(12/15),Ⅲtime of 83.3%(5/6), IV time of 100%(2/2).⑤105 example renal tumors, both union diagnosis's sensitivity was 94.1%(48/51), the specificity was 96.3%(52/54), the accuracy was 95.2%(100/105).51 example kidney cancer by stages, Both union diagnoses the rate of accuracy by stages respectively was:Ⅰtime 89.3%(25/28),ⅡTime 86.7%(13/15),ⅢTime 100.0%(6/6),ⅣTime 100%(2/2).Conclusion:Color Doppler ultrasound and CT are an important means for examination of renal tumors,both can judgment the nature of renal tumor accurately, in the diagnosis the nature of renal tumor and the kidney cancer by stages, the difference non-statistics significance (P>0.05). Supersonic is the screening kidney tumor first choice inspection method, its low in price, non-ion irradiation, easy to do, the patient easy to accept. Regarding complex renal tumor's diagnosis, but also needs many kinds of phantom study inspections the union application, both generalized analysis, can raise the diagnosis rate of accuracy.