Comparative Diagnostic Performance of Color Doppler Flow Imaging, MicroFlow Imaging and Contrast-enhanced Ultrasound in Solid Renal Tumors.

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Academic Radiology Pub Date : 2025-01-17 DOI:10.1016/j.acra.2024.12.057

Chunxiang Li, Lisha Qi, Changyu Geng, Huiting Xiao, Xueqing Wei, Tan Zhang, Zhenting Zhang, Xi Wei

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Abstract

Rationale and objectives: Accurate distinguish malignant from benign renal masses remains a challenge for radiologists. The purpose of this study was to evaluate the value of Color Doppler Flow Imaging (CDFI), MicroFlow Imaging (MFI) and Contrast-enhanced Ultrasound (CEUS) in diagnosing solid renal tumors.

Materials and methods: A total of 291 patients with 300 solid renal tumors pathologically confirmed were retrospectively analyzed between January 2020 and December 2022. Each patient underwent CDFI, MFI, and CEUS examinations before surgery. The diagnostic efficacy of CDFI, MFI and CEUS in assessing renal tumors was compared based on blood flow grade, vascular morphology and CEUS characteristics.

Results: MFI identified 243 renal lesions (81%) with blood flow grade (2, 3) and vascular morphology (IV, V), significantly outperforming CDFI, which detected 147 cases (49%). MFI demonstrated statistically significant differences in detecting blood flow signals and predicting renal malignancy compared to CDFI (p < 0.001). In CEUS examination, significant differences were observed in wash-in, enhancement intensity, wash-out, and perilesional rim-like enhancement of the contrast agent between malignant and benign renal lesions (all p < 0.001). The areas under the receiver operating characteristic curves (AUCs) for MFI and CEUS were 0.838 and 0.788, respectively, both higher than that for CDFI (0.695). In diagnosing solid renal tumors, MFI and CEUS showed significant differences compared to CDFI (p < 0.05), although no significant difference was found between MFI and CEUS (p = 0.075). The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CDFI, MFI and CEUS were as follows: 0.600 vs.0.893 vs.0.920; 0.554 vs. 0.920 vs.0.984; 0.837 vs. 0.755 vs.0.592; 0.946 vs. 0.951 vs.0.925; 0.268 vs. 0.649 vs.0.879.

Conclusion: MFI demonstrates higher sensitivity in detecting microvascular signs of renal tumors compared to CDFI. Moreover, MFI exhibits comparable diagnostic performance to CEUS in distinguishing malignant from benign renal masses.

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彩色多普勒血流显像、微血流显像和增强超声在实体肾肿瘤诊断中的比较研究。

基本原理和目的：准确区分良性和恶性肾肿块对放射科医生来说仍然是一个挑战。本研究旨在探讨彩色多普勒血流显像（CDFI）、微血流显像（MFI）和超声造影（CEUS）对肾实性肿瘤的诊断价值。材料与方法：回顾性分析2020年1月至2022年12月病理证实的肾实体瘤患者291例300例。术前均行CDFI、MFI、超声造影检查。根据血流分级、血管形态和超声造影特征，比较CDFI、MFI和超声造影对肾脏肿瘤的诊断效果。结果：MFI发现肾病变243例（81%），血流等级为2、3级，血管形态为IV、V级，明显优于CDFI发现147例（49%）。与CDFI相比，MFI在检测血流信号和预测肾恶性肿瘤方面具有统计学意义（p < 0.001）。在超声造影检查中，对比剂在恶性和良性肾脏病变的冲洗、增强强度、冲洗和病灶周围边缘样增强方面存在显著差异（均p < 0.001）。MFI和CEUS的受试者工作特征曲线下面积（auc）分别为0.838和0.788，均高于CDFI（0.695）。在诊断实体性肾肿瘤方面，MFI和CEUS与CDFI相比差异有统计学意义（p < 0.05）， MFI与CEUS之间无统计学差异（p = 0.075）。CDFI、MFI和CEUS的诊断准确性、敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为：0.600 vs.0.893 vs.0.920；0.554 vs 0.920 vs 0.984；0.837 vs 0.755 vs 0.592；0.946 vs 0.951 vs 0.925；0.268 vs 0.649 vs 0.879。结论：MFI对肾脏肿瘤微血管征象的检测灵敏度高于CDFI。此外，MFI在区分良性和恶性肾肿块方面表现出与超声造影相当的诊断性能。

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来源期刊

Academic Radiology 医学-核医学

CiteScore

7.60

自引率

10.40%

发文量

432

审稿时长

18 days

期刊介绍： Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.