超声造影和增强CT对肾细胞癌分型的对照研究  

Comparative Study on the Features of Subtype of Renal Cell Carcinoma on Contrast-enhanced Ultrasound and Contrast-enhanced Computed Tomography

作　　者：胡海燕[1] 赵艳娥[1] 魏淑萍[2] 马思懿[1] 张宗军[1] 

机构地区：[1]南京大学医学院临床学院南京军区南京总医院医学影像科 [2]南京军区南京总医院超声诊断科

出　　处：《中国医学计算机成像杂志》2014年第1期59-63,共5页Chinese Computed Medical Imaging

摘　　要：目的:分析三种亚型肾细胞癌的超声造影和增强CT表现,探讨两种方法在肾细胞癌分型中的价值。方法:对117例肾细胞癌患者分别行超声造影(104例)和三期增强CT(108例)检查,对不同亚型肾细胞癌的超声造影和增强CT表现进行比较。结果:超声造影上37例透明细胞癌表现为"快进快出",14例"同进同出",高于乳头状细胞癌和嫌色细胞癌(P<0.01);52例透明细胞癌呈高增强,高于乳头状细胞癌和嫌色细胞癌(P<0.01)。在增强CT动脉期上,透明细胞癌的强化程度明显高于嫌色细胞癌和乳头状细胞癌(P<0.01);肿瘤肾皮质比分别为74.7%、44%和24.5%。超声造影和增强CT在鉴别透明细胞癌和非透明细胞癌的敏感性分别为75.36%和85.51%,特异性为65.71%和64.10%。结论:超声造影与增强CT在肾细胞癌亚型鉴别上均具有较高的敏感性和特异性,两者结合应用有助于提高对肾细胞癌亚型的鉴别。Purpose： To investigate the findings of three common subtypes of renal cell carcinoma （RCC） on contrast-enhanced ultrasound （CEUS） and three-phase enhanced spiral CT scan. Methods： One hundred and seventeen patients were confirmed by pathologic examination, of which 104 patients underwent CEUS, and 108 patients underwent contrast-enhanced computed-tomography （CECT）. The CEUS and enhanced CT results and the pathologic results of them were compared. Results： By CEUS, thirty-seven clear cell carcinoma showed ＂quick in and out＂ pattern and 14 showed ＂simultaneous in and out＂, the incidence rate of them was higher than that of papillary carcinoma and chromophobe carcinoma （P〈0.01）. Fifty-two clear cell carcinoma showed higher reinforcement than papillary carcinoma and chromophobe carcinoma （P 〈0.01）. On CECT, the clear cell type showed higher enhancement than chromophobe and papillary types （P〈0.01）. The enhancement ratio of tumor to kidney for clear cell type was 74.7%, for chromophobe type was 44% and for papillary type was 24.5%. The corresponding sensitivity and specificity for differentiating clear cell type from non-clear cell type RCC were 75.36% and 65.71% by CEUS, 85.51% and 64.10% by CECT. Conclusion： For differentiating RCC subtypes, CEUS and CECT have higher sensitivity and specificity rate. CEUS and CECT all play important roles in diagnosing and typing of renal cell carcinomas.

关 键 词：肾细胞癌 亚型 超声造影 体层摄影术 X线计算机 

分 类 号：R737.11[医药卫生—肿瘤] R445.1[医药卫生—临床医学]