高帧率造影增强超声在实体肾肿瘤的定性与定量分析

旨在利用定性和定量方法分析高帧率造影增强超声（H-CEUS）在实体肾肿瘤中的表现。回顾分析了75例接受术前常规超声（US）、常规造影增强超声（C-CEUS）及H-CEUS检查的肾肿瘤患者，共涉及89个肾块。根据增强CT和病理结果，将肾块分为良性组（30个）和恶性组（59个）。通过超声观察肿块的位置、直径、形状、边界、钙化及彩色多普勒血流成像（CDFI）。对C-CEUS和H-CEUS的影像特征进行了定性与定量分析。采用χ²检验或Fisher精确概率法比较良恶性组的超声影像特征，以及C-CEUS与H-CEUS在良恶性组中的影像特征。非参数的Mann-Whitney检验用于比较C-CEUS与H-CEUS的时间强度曲线（TIC）参数差异。结果显示，恶性与良性组在性别、手术方式、回声特性及CDFI方面存在显著差异（p=0.003，<0.001，<0.001，=0.0003）。质性分析还发现，恶性组中C-CEUS与H-CEUS在洗脱方式和充盈方向上存在显著差异（p=0.041，0.002）。此外，良性组中两种造影模式的增强均匀性也有显著差异（p=0.009）。定量分析显示，H-CEUS模型中的峰值强度（PI）、减速时间（DT）/2、曲线下面积（AUC）及平均转换时间（MTT）均明显低于C-CEUS模型（所有p<0.001）。相反，升降曲线的上升坡度（AS）在恶性组中在H-CEUS中显著高于C-CEUS（p=0.048）。在肾肿瘤中，H-CEUS显示肿块内部增强更清晰，洗脱时间也有变化。定量TIC参数PI、DT/2、AUC和MTT在H-CEUS中均低于C-CEUS，两者的定性和定量分析均表明，H-CEUS优于C-CEUS在显示实体肾肿瘤的特征方面。

To analyze the characteristics of high-frame-rate contrast-enhanced ultrasound (H-CEUS) in solid renal tumors using qualitative and quantitative methods.Seventy-five patients who underwent preoperative conventional ultrasound (US), conventional contrast-enhanced ultrasound (C-CEUS), and H-CEUS examination of renal tumors were retrospectively analyzed, with a total of 89 renal masses. The masses were divided into the benign (30 masses) and malignant groups (59 masses) based on the results of enhanced computer tomography and pathology. The location, diameter, shape, border, calcification, and color doppler blood flow imaging (CDFI) of the lesions were observed by US, and the characteristics of the C-CEUS and H-CEUS images were qualitatively and quantitatively analyzed. The χ² test or Fisher's exact probability method was used to compare the US image characteristics between the benign and malignant groups, and the image characteristics of C-CEUS and H-CEUS between the benign and malignant groups. Moreover, the nonparametric Mann-Whitney test was used to compare the differences in C-CEUS and H-CEUS time-intensity curve (TIC) parameters.Significant differences in gender, surgical approach, echogenicity, and CDFI were observed between the malignant and benign groups (p = 0.003, < 0.001, < 0.001, = 0003). Qualitative analysis also revealed significant differences in the mode of wash-out and fill-in direction between C-CEUS and H-CEUS in the malignant group (p = 0.041, 0.002). In addition, the homogeneity of enhancement showed significant differences between the two contrast models in the benign group (p = 0.009). Quantitative analysis indicated that the TIC parameters peak intensity (PI), deceleration time (DT) /2, area under the curve (AUC), and mean transition time (MTT) were significantly lower in the H-CEUS model compared to the C-CEUS model in both the benign and malignant groups. (all p < 0.001). In contrast, ascending slope of rise curve (AS) was significantly higher in the H-CEUS model compared to the C-CEUS model in the malignant group (p = 0.048).In renal tumors, H-CEUS shows clearer internal enhancement of the mass and the changes in the wash-out period. The quantitative TIC parameters PI, DT/2, AUC, and MTT were lower in H-CEUS compared to C-CEUS. Both the quantitative and qualitative analyses indicated that H-CEUS better displays the characteristics of solid renal masses compared with C-CEUS.