[The application value of contrast-enhanced ultrasound in the surgery of renal masses]

Objective: To investigate the clinical value of contrast-enhanced ultrasound in the diagnosis of renal masses. Methods: A total of 50 patients with renal masses who underwent partial nephrectomy were analyzed from January 2014 to October 2016 in the Department of Urology of China-Japan Union Hospital of Jilin University. In the intraoperative contrast-enhanced ultrasound, the characteristics of ultrasound imaging were recorded including location, size, boundary, echo, real-time internal and peripheral blood and renal pelvis distance, artery, guidance on the selection of surgical methods, intraoperative real-time estimation of the extent of tumor resection. Results: In the 50 patients, there were 49 cases enhancement in the imaging of the cystic masses, 1 case had no enhancement.Contrast-enhanced ultrasound assisted clinical accurate positioning 34 masses which were in the renal contour and not convex.And 15 patients were found main arteries of renal occupied lesions.There were 38 cases whose distance from occupying to pelvis was more than 0.5 cm, and maintained the original operation scheme for partial nephrectomy.There were 12 cases whose distance from occupying to pelvis was less than 0.5 cm, and proceeded radical resection. Conclusions: Intraoperative contrast-enhanced ultrasound can provide a more accurate imaging basis for the surgeon in partial nephrectomy.It's of great significance for the correct choice of surgical procedures, and can reduce or avoid the occurrence of postoperative complications.

目的: 探讨超声造影在肾占位性病变手术中的临床应用价值。 方法: 吉林大学中日联谊医院泌尿外科2014年1月至2016年10月拟采取肾部分切除术的肾占位患者共50例,于术中行常规超声及超声造影检查。在术中超声造影检查中实时观察病变位置、大小、边界、回声、内部及周边血流情况、与肾盂距离、供血动脉等,指导手术方式选择,术中实时判断肿瘤切除程度。 结果: 本组50例患者中,49例实质性占位术中造影时均见增强,1例囊性占位造影时无增强。术中超声造影协助临床准确定位,位于肾轮廓内、无外凸的占位病变34例,术中判断肾占位主要供血动脉15例;术中超声造影显示占位距肾盂≥0.5 cm者38例,维持原手术方案行肾部分切除;<0.5 cm者12例,行肾脏根治性切除术。 结论: 术中超声造影在肾部分切除术中能够为外科医生提供更准确的影像学依据,对手术方案的正确选择,减少或避免术后并发症的发生具有重要意义。.

Zhonghua yi xue za zhi. 2017 Apr 18 [Epub]

M H Liu, J H Shi, Q M H Wangqi, Y Q Lin, Z X Sun

Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun 130033, China.