摘要
目的探讨超声造影(CEUS)评估肾脏外伤分级的临床价值。方法对45例肾脏外伤疑诊患者行CEUS检查,并对肾损伤分级诊断结果与CT或手术分级结果相对比分析。结果45例患者中肾脏外伤43例,CEUS检出40例。CEUS分级为Ⅰ级损伤12例,Ⅱ级损伤11例,Ⅲ级损伤7例,Ⅳ级损伤8例,Ⅴ级损伤2例。CEUS漏诊3例,均为Ⅰ级损伤,另有3例出现分级错误,其中1例将Ⅲ级高估为Ⅳ级,2例将Ⅳ级低估为Ⅲ级。超声造影评价肾损伤的分级与CT或手术分级的一致性指数为0.831(P=0.000),两者的一致性很好。CEUS检出肾脏外伤病灶的敏感性为93.0%,特异性100.0%,准确性93.3%。结论CEUS能较准确判断肾脏损伤的分级,正确指导临床减少对Ⅰ、Ⅱ、Ⅲ级肾损伤患者的不必要手术探查,避免对Ⅳ、Ⅴ级肾损伤患者盲目保守治疗,为保留肾单位的治疗赢得时间。
Objective To evaluate the value of contrast-enhanced ultrasound(CEUS) in the grading of kidney trauma.Methods Totally 45 patients underwent CEUS for trauma grading combined with treatment and analysed retrospectively.All the results were compared with those of surgical operations and contrast-enhanced CT.Results In 45 cases,43 cases were confirmed kidney trauma.CEUS showed 40 focuses,which was classified as follow:grade Ⅰ in 12 cases,grade Ⅱ in 11;grade Ⅲ,7;grade Ⅳ,8;grade Ⅴ,2.CEUS grading was consistent with surgical operations and contrast-enhanced CT.The agreement Kappa was 0.831.The agreement between CEUS and CT was good.Sensitivities,specificities,and accuracies via CEUS were 93.0%,100.0% and 93.3%,respectively.Conclusions CEUS could accurately grade kidney trauma.It may guide to decrease unnecessary surgerly in grade Ⅰ,Ⅱ and Ⅲ,and to avoid blind conservative treatment in grade Ⅳ,and Ⅴ and to get time for saving nephrons.
出处
《中华医学超声杂志（电子版）》
2007年第6期363-365,共3页
Chinese Journal of Medical Ultrasound(Electronic Edition)
关键词
超声检查
造影剂
肾
外伤
Ultrasonography
Contrast media
Kidney
Trauma
