肾透明细胞癌与乏脂肪血管平滑肌脂肪瘤的CT鉴别诊断  

CT differential diagnosis of clear cell renal carcinoma and angiomyolipoma with minimal fat

作　　者：王超[1] 王龙胜[2] 田莹 邱晓晖[1] 章辉庆[1] 夏俊立[1] 

机构地区：[1]亳州市人民医院南院影像中心,安徽亳州236800 [2]安徽医科大学第二附属医院放射科,安徽合肥230601

出　　处：《实用放射学杂志》2018年第2期245-248,266,共5页Journal of Practical Radiology

摘　　要：目的 探讨肾透明细胞癌（ccRCC）与乏脂肪血管平滑肌脂肪瘤（AMLmf）的CT表现，以提高两者的CT诊断准确性。 法 回顾性分析经病理证实的55例ccRCC与12例AMLmf的CT表现，包括肿块平扫和3期增强CT值、肿瘤强化率（△R1、△R2、△R3）、最大径、强化均匀性、肿瘤主体位置、皮质掀起征等，并进行统计学分析。 结果 ccRCC组肿瘤最大径、实质期肿瘤CT值、强化率△R1、△R2、△R3均明显高于AMLmf组，平扫CT值明显低于AMLmf组（P均〈0.05），而皮髓期及排泄期肿瘤CT值二者差异均无统计学意义（P均〉0.05）。AMLmf组肿瘤主体位于肾外比率明显高于ccRCC组（P=0.020），肿瘤主体位置以及皮质掀起征与肿瘤最大径之间差异均无统计学意义（P均〉0.05）。ccRCC组皮髓期、实质期及排泄期肿瘤强化均匀性低于AMLmf组（P均〈0.05）。结论 ccRCC平扫CT值低于AMLmf，强化率高于AMLmf，强化均匀性较AMLmf差。AMLmf主体位于肾外较ccRCC常见，皮质掀起征及肿瘤主体位置与肿瘤大小无关。Objective To investigate the CT features of clear cell renal carcinoma （ccRCC） and angiomyolipoma with minimal fat （AMLmf） and to improve the CT diagnostic accuracy of these two diseases.Methods The CT features of 55 patients with pathologically- confirmed ccRCC and 12 patients with pathologically-confirmed AMLmf were analyzed retrospectively, including the CT value in both plain and tri-phase enhanced CT scan,tumor enhancement rate （/kR1 ,AR2 ,ARa ） ,maximum diameter, enhanced homogeneity,location of the main tumor, cortex raising signs,etc.The statistical analysis was carried orLResults The maximum diameter,the CT value in parenchymal phase,enhancement rate （AR1 ,AR2, AR3 ） of tumors in ccRCC group were significantly higher than those of tumors in AMLmf group, and the CT value in plain CT scan in ccRCC group was significantly lower than that in AMLmf group （all P〈0.05）. No statistically significant difference was found in the CT value of the tumor in corticomedullary phase and in excretion phase （both P〉0.05 ）.The rate of extrarenally-located main tumors of AMLmf group was significantly higher than that of ccRCC group （P = 0.020）, the location of main tumors and cortex raising signs showed no statistically significant difference with the maximum tumor diameter （both P〉0.05 ）.The enhanced homogeneity of the tumor in corticomedullary phase, parenchymal phase and excretion phase in ccRCC group was lower than that in AMLmf group （all P〈0.05）.Conclusion The CT value in plain CT scan in ccRCC group is lower than that in AMLmf group;the enhancement rate of the ccRCC group is higher than that of the AMLmf group; the enhanced homogeneity of the ccRCC group is worse than that of the AMLmf group.The extrarenally-located main tumors are more commonly seen in AMLmf than in ccRCC,and the cortex raising signs and the location of main tumors are unrelated to the size of the tumor.

关 键 词：肾透明细胞癌 血管平滑肌脂肪瘤 计算机体层成像 

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