乏脂肪肾血管平滑肌脂肪瘤与肾细胞癌的影像鉴别征象的应用价值评估  

Imaging Features in Differentiating Renal Angiomyolipoma Absent of Fat from Renal Cell Carcinoma

作　　者：孟庆成[1] 王立峰[1] 贾丙鑫[1] 黎海亮[1] 赵二江[2] 魏晓燕[1] 陈学军[1] 

机构地区：[1]郑州大学附属肿瘤医院(河南省肿瘤医院)放射科,450008 [2]郑州大学附属肿瘤医院(河南省肿瘤医院)病案室,450008

出　　处：《临床放射学杂志》2013年第2期225-228,共4页Journal of Clinical Radiology

摘　　要：目的探讨乏脂肪肾血管平滑肌脂肪瘤(RAML)与肾细胞癌(RCC)的影像鉴别征象的临床应用价值研究。方法搜集经术后病理和临床综合检查证实的乏脂肪AML 21例及无明显周围器官侵犯或远处转移的RCC29例,并随机编号;抽取影像学诊断医师60名,按工作年限分为3组,每组各20名。确定所选影像鉴别征象:假包膜、病灶数目、钙化及出血、强化特征、病灶与皮质交角。公布鉴别征象前后分别对3组研究对象的诊断正确率,采用SPSS 17.0统计分析软件进行处理,采用χ2检验。结果总体受试人员初次诊断正确1489例(49.96%),二次诊断正确1635例(54.50%),二者差异有显著统计学意义(χ2=14.235,P=0.00)。工作<5年组鉴别诊断正确率由47.5%升至55.1%;5～10年组正确率由49.8%升至54.7%,统计分析差别有显著性(χ2=11.560,4.810;P=0.001,0.043),>10年组诊断正确率由51.6%升至53.7%,差异无统计学意义(χ2=0.884,P=0.347)。结论在临床影像学医师中,尤其在副主任医师以下职称影像学医师中进行RCC与乏脂肪RAML影像鉴别征象的普及对提高临床诊断水平,提高诊断正确率具有一定的价值。Objective To evalute the value of imaging features in differentiating renal Angiomyolipoma（RAML） absent of fat from renal cell carcinoma. Methods 21 cases of RAML absent of fat and 29 cases of renal cell carcinoma （RCC） confirmed by pathology were selected. Sixty radiologists were divided equally into three groups depend on the years of pro- fessional work. The characters of differentiating included pseudocapsule, the number of lesions, calcification and hemor- rhage, enhanced character, angle between lesion and renal cortex were selected. The 60 doctors should made the diagnosis two times before and after knowing the differentiating imaging characters. The diagnostic accuracy was analyzed of different doctor groups. Results The total 1489 cases （49.96%）were correctly diagnosed at first time, then increased to 1635 ca- ses （54.50%）at second time, which has significant differences（ X^2 = 14. 235 ,P = 0.00）. The diagnostic accuracy of two times in groups who worked less than 5 years and 5 - 10 years were 47.5% increased to 55.1% and 49.8% to 54.7%. The both two group doctors had significant differences of diagnostic accuracy between two times （X^2 = 11. 560,4.810;P = 0. 001,0.043）. But the diagnostic accuracy of group who worked more than 10 years was 51.6% increasedto 53.7% at two times,which has no statistic differences （X^2 = 0. 884, P = 0. 347）. Conclusion In order to improve the diagnostic ac- curacy, it is necessary for the radiologists, especially the young doctors who worked less than 10 years, to know well the imazing characters in differentiatinz RAML from renal cell carcinoma.

关 键 词：肾血管平滑肌脂肪瘤 肾细胞癌影像征象 

分 类 号：R737.11[医药卫生—肿瘤]