平扫CT鉴别肾透明细胞癌与高密度肾囊肿的应用价值  

Application value of unenhanced CT in differential diagnosis of renal cell carcinoma and high density renal cyst

作　　者：罗实[1] 张莹莹[2] 徐荣天[3] 

机构地区：[1]沈阳市第四人民医院放射科,辽宁沈阳110031 [2]辽宁省肿瘤医院放射科 [3]中国医科大学附属第一医院放射科

出　　处：《实用放射学杂志》2014年第11期1855-1857,共3页Journal of Practical Radiology

基　　金：辽宁省教育厅科研项目计划（L2010665）.

摘　　要：目的探讨应用CT值和病灶的均匀性来鉴别小肾透明细胞癌与高密度肾囊肿的价值。方法回顾性分析经手术病理证实的38例小肾透明细胞癌及经随访和CT增强证实的58例高密度肾囊肿的平扫CT图像，测量每个病灶的平扫CT值和均匀性，并对相应资料进行统计学分析。结果小肾透明细胞癌平扫CT值为（35．5±10．1）HU（范围20～60．3HU），高密度肾囊肿平扫CT值为（70±15．2）HU（范围29-95HU），二者差异有统计学意义（P〈0．001）。高密度肾囊肿密度均匀多见（47例，81．03％），小肾透明细胞癌密度不均匀多见（29例，76．32％），二者差异有统计学意义（P〈0．001）。CT值的阈值为51．5HU时，敏感性为89．7％，特异性为92.1％。结论平扫CT扫描有助于鉴别小肾透明细胞癌与高密度肾囊肿，并可对下一步的检查提供合理的建议。Objective To investigate the value of distinguishing small clear cell renal cell carcinoma and high-attenuation renal cysts by applying unenhanced CT value and homogeneity of the esions. Methods Retrospective analysis of 38 cases of small renal cell carcinoma confirmed by operation and pathology and 58 cases of high-attenuation renal cyst that were confirmed by enhanced CT ,and measured CT value and homogeneity of each mass, and did statistical analysis for corresponding datas. Results The CT value of small clear cell renal cell carcinoma was （35.5 ± 10. 1） HU （range 20-60.3 HU）. The CT value of high-attenuation renal cysts was （70 ± 15. 2） HU （range 29 - 95 HU）. Difference of the two groups had statistical significance （P〈0. 001）. For high-attenuation renal cysts, uniform density often can be seen（ 47 cases, 81. 03 % ）. For small clear cell renal cell carcinoma, uneven density often can be seen （29 cases, 76.32%）. Difference of the two groups had statistical significance （P〈0. 001）. When optimal cut-off of CT value determined by ROC was 51. 5 HU, the sensitivity and specificity were 89. 7 % and 92. 1 %, respectively. Conclusion Unenhanced CT may be helpful in distinguishing small clear cell renal cell carcinoma and high-attenuation renal cysts, which can provide reasonable suggestions on the next identification examinations.

关 键 词：肾 计算机体层成像 对比分析 

分 类 号：R737.11[医药卫生—肿瘤] R692[医药卫生—临床医学]