| Objective: In order to perform early diagnose, early treatment and to promote the life quality of patients, application value of ultra sonic imaging in the identifying of innocent lesion and malignancy lesion in kidney is discussed.Method: 50 patients with mass who are diagnosed as kidney lesion from Mar 2014 to Feb 2015 are chosen as study subjects in affiliated hospital of Qinghai University. Detailed information such as general status and body sign are collected. Regular 2d and color Doppler ultrasound scanning before imaging are performed in patients. In order to make a preliminary diagnostic imaging inspection, size, border, location and blood flow of the mass are inspected. Sono Vue of Gracco Company is chosen as ultrasonic contrast agents. Mixing with 5 ml of saline with it is made before scanning. Horizontal position and lateral position are chosen during multi-layer ultra sonic scanning. The layer that could display lesion and tissue surround kidney simultaneously is chosen. 5ml saline is intravenously injected through median cubital vein after the injection of 5 ml contrast agent after ultrasonic instrument has been adjusted into imaging mode. A real-time continuously dynamic observation is chosen to observe blood perfusion situation of lesion and tissue surrounding kidney. Images are saved after a 6 min imaging process. In order to further analyze the image, video is replayed after finishing imaging. Quantitative analysis of images by sonic quantitative analyzing software is performed. Arriving time for contrast agent, peak time, border time, peak strength and self-control analysis of renal cortex is performed according to TIC. The situation that arriving time is earlier than self renal cortex is called fast-advance type. The situation with a later arriving time than self renal cortex is called slow-advance type. The situation that border time is earlier than renal cortex surrounding is call fast-retreat type. Otherwise, it’s called slow-retreat type. Analysis between the pathological result of operation or puncture and the result of ultra sonic imaging is performed.Result:1. 22 cases of innocent mass are found in 50 kidney lesion in 50 patients inspected. No enhancing, even enhancing and centripetal enhancing are found in most ultrasonic features. Clean and finishing border of mass after enhancing could be found. Simultaneously advancing and retreating of TIC could often be found. Fast-advancing and slow-retreat could also be commonly found.2. 27 cases of malignancy lesion are found in 50 kidney lesion in 50 patients inspected. Uneven enhancing and diffusive enhancing are found in most ultrasonic features. Extending of contrast agent defect area in central focus could be seen after enhancing. Pseudocapsule can be seen in most renal cell carcinoma. Fast-advancing & slow-retreating and slow-advancing & slow retreating are common in TIC.3. No significant difference of AT could be found among imaging parameters of innocent kidney mass. On the contrary, significant difference is found in PI, TTP and AUC of images for innocent mass.Conclusion: Contrast enhancement patterns of benign and malignant renal masses on ultrasound and characteristics of their time-intensity curve parameters are statistically significantly different. Malignant renal prognosis should be evaluated preoperatively, and individualized treatment programs should be developed, so that patients can have the chance to receive the best treatment and have favorable prognosis. |
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