不同肾癌亚型CT影像学的对照研究  

Comparative study on spiral CT features of three subtypes of renal cell carcinoma

作　　者：张锦[1] 甘卫东[1] 姚林方[1] 张古田[1] 李笑弓[1] 郭宏骞[1] 

机构地区：[1]南京大学医学院附属鼓楼医院泌尿外科,南京210008

出　　处：《中华腔镜泌尿外科杂志（电子版）》2016年第2期22-25,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：国家自然科学基金面上项目(81572512);江苏省自然科学基金(BK20131281)

摘　　要：目的探讨不同肾癌亚型的影像学特征,评估螺旋CT扫描在其诊断鉴别中的应用价值。方法回顾性分析75例经手术及穿刺活检病理证实肾细胞癌患者的影像学资料,其中肾透明细胞癌30例,乳头状肾细胞癌26例,Xp11.2易位/TFE3基因融合相关性肾癌(简称Xp11.2易位型肾癌)19例。均行多层螺旋CT平扫及增强检查,比较平扫、增强动脉期的强化幅度及特征。结果肾透明细胞癌、乳头状肾细胞癌及Xp11.2易位型肾癌的平均CT值增强量(即增强扫描动脉期肿瘤最大横截面平均CT值-平扫相肿瘤最大横截面平均CT值)分别为(59.87±29.21)HU、(28.88±23.29)HU及(37.22±35.96)HU,三者间差异有统计学意义(P<0.05),肾透明细胞癌强化程度明显高于后两者,而乳头状肾细胞癌与Xp11.2易位型肾癌强化幅度差异无统计学意义(P>0.05)。结论不同肾癌亚型所表现出的影像学特征有助于肿瘤的初步诊断和术前预测。Objective To investigate computed tomography（CT） features of three subtypes of renal cell carcinoma so that to evaluate the significance of spiral CT scan in differential diagnosis of them.Methods The spiral CT data of 75 cases of renal cell carcinoma proved by biospy and postoperative pathology, including 30 case of clear cell renal cell carcinoma（CCRCC）, 26 papillary renal cell carcinoma（PRCC）, 19 renal cell carcinoma associated with Xp11.2 translocation and TFE gene fusion（Xp11.2RCC） were analyzed retrospectively. Enhancement degree and characteristics in plain CT scan and arterial phase of enhancement were compared. Results The average enhanced CT value（the average CT value in maximum cross sectional area of arterial phase-the average CT value in maximum cross sectional area of plain CT scan） of CCRCC, PRCC and Xp11.2 RCC was（59.87±29.21） HU,（28.88±23.29） HU and（37.22±35.96） HU respectively, showed significantly statistical differences among the three subtypes（P〈0.05）. On arterial phase images, CCRCC showed greater signal intensity change than the others, there was no significant difference in the degree of enhancement between PRCC and Xp11.2 RCC（P〈0.05）. Conclusion Different subtypes of renal cell carcinoma showed different CT features and dynamic enhanced CT scan is helpful in differential diagnosis.

关 键 词：肾脏肿瘤 亚型 影像学 CT值 

分 类 号：R737.11[医药卫生—肿瘤]