CT双相扫描鉴别乏脂肪性肾血管平滑肌脂肪瘤与肾细胞癌的价值  

The vlaue of biphase helical CT differentiating AML with minimal fat from renal cell carcinoma

作　　者：林均海[1] 葛全序[1] 姜华伟[1] 

机构地区：[1]威海市文登中心医院影像中心

出　　处：《医学影像学杂志》2006年第9期941-943,共3页Journal of Medical Imaging

摘　　要：目的:通过比较乏脂肪性肾血管平滑肌脂肪瘤(AML)与肾细胞癌(RCC)的各种CT特征,评价CT在鉴别诊断中的价值。方法:回顾性分析了7例均病理证实的乏脂肪性AML和22例RCC的CT平扫和双相增强扫描(皮髓质相和早期分泌相)资料。结果:乏脂肪AML呈不均匀密度2例(28.6%),RCC组,不均匀密度14例(63.2%),两组不均匀率差异显著(P<0.05)。均匀强化和延迟强化发生率AML组为71%(5/7)和57.1%(4/7),RCC组为14%(3/22)和9%(2/22),经多变量逻辑回归分析,肿瘤的强化模式是鉴别AML和RCC的有价值的预测指标,其阳性和阴性预测值分别为80%(4/5)和86.9%(20/23)。结论:应用CT对比剂双期扫描,肿瘤的强化模式对于鉴别AML和RCC具有重要价值。Objective：To evaluate the value of CT in differentiating angiomyolipoma （AML） with minimal fat from ranal cell cancimoma（RCC） by comparing their various CT features. Methods： The CT features（ unenhanced, corticomedullary, and early excretory phase scanning）of seven cases with AML and 22 cases with RCC proved pathologically were analysed retrospectively. Results： 28.6 % （2/ 7） of AML and 63.2% （14/22） of RCC manifest a heterogeneous attenuation in unenhanced CT scan, Homogeneous enhancement were observed in 71% of AML vs 14% of RCC ,and prolonged enhancement pattern were observed in 57. 1%of AMLvs 9% of RCC. When both CT findings were used as a criteria for differentiating AML from RCC, positive and negative predictive values were 80% （4/5） and 86.9% （20/22） respectively. Conclusion： Biphase helical CT is useful in differentiating AML with minimal fat from RCC, with homogeneous tumor enhancement and prolonged enhancement pattern being the most valuable CF findings.

关 键 词：乏脂肪性肾血管平滑肌脂肪瘤 肾细胞癌 双期扫描 体层摄影术 X线计算机 

分 类 号：R737.11[医药卫生—肿瘤] R814.42[医药卫生—临床医学]