CT在肾脏富血供肿瘤鉴别诊断中的价值  

The Application of CT in the Differential Diagnosis of Hypervascular Renal Tumor

作　　者：高玉青 刘斌[1] GAO Yu-qing;LIU Bin(Department of Radiology,The First Affiliated Hospital of Anhui Medical College,Hefei 230022,Anhui Province,China)

机构地区：[1]安徽医科大学第一附属医院放射科,安徽合肥230022

出　　处：《中国CT和MRI杂志》2018年第12期106-109,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨肾脏富血供肿瘤CT平扫及动态增强影像学特点,提高对肾脏富血供肿瘤影像学表现的认识及鉴别诊断水平。方法回顾性分析109例(其中透明细胞癌79例,乏脂型血管平滑肌脂肪瘤14例,嫌色细胞癌9例,嗜酸性细胞腺瘤7例)经手术病理证实的肾脏肿瘤。结果(1)透明细胞癌出现囊变坏死的概率(87.34%)明显高于其他三种肿瘤;(2)中央瘢痕对嗜酸性细胞腺瘤的诊断有一定的帮助,可视为其特征性CT表现,但不是其特异性征象;(3)"成角征"对于肿瘤定性诊断具有统计学意义;(4)嫌色细胞癌与其他三种肿瘤的CT值间差异有统计学意义,实质期及延迟期嗜酸性细胞腺瘤与其他三组的CT值间差异有统计学意义,乏脂型血管平滑肌脂肪瘤与透明细胞癌的CT值间差异无统计学意义。结论 CT平扫及增强扫描对肾脏富血供肿瘤的鉴别诊断有一定价值,有利于指导临床及预后。Objective To improve the understanding and differential diagnostic level of imaging features of hypervascular renal tumors by investigating the imaging characteristics of CT scan and three phase dynamic enhanced.Methods A total of 105 cases including 79 cases of renal clear cell carcinoma and 14 cases of lipoprotein-deficient angiomyolipoma,8 cases of chromophobe cell tumor and 4 cases of eosinophil adenoma were analyzed retrospectively.The cases were all confirmed as renal tumors by pathology surgery.Results(1)The probability of occurrence of cystic necrosis of clear cell carcinoma(87.34%)was significantly higher than that of the other three types of tumors.(2)The central scar is helpful to the diagnosis of eosinophil adenoma,which can be regarded as its CT features,but not the specific sign.(3)"Angular sign"was statistically significant for the qualitative diagnosis of tumors.(4)The diffrence of CT values between chromophobe cell tumor and other three kinds of tumors was significant statistically.The difference of CT values between eosinophil adenoma and the other three groups in parenchymal and excretory period was statistically significant.The difference of CT values between lipoproteindeficient angiomyolipoma and renal clear cell carcinoma was not statistically significant.Conclusion CT scan and enhancement are worth of diagnosing hypervascular renal tumors.It is helpful to guide the clinical and prognosis.

关 键 词：肾脏 CT 透明细胞癌 嫌色细胞癌 乏脂性血管平滑肌脂肪瘤 嗜酸性细胞腺瘤 

分 类 号：R445.3[医药卫生—影像医学与核医学] R737.11[医药卫生—诊断学]