肿瘤体积与CT动态增强特征在肾盂癌鉴别诊断中的应用  

Application of tumor volume and the characteristic of change of CT values in enhanced CT in diagnosis of renal pelvic carcinoma

作　　者：周文文 王长军 张楠[3] 郭凌飞[3] ZHOU Wenwen;WANG Changjun;ZHANG Nan;GUO Lingfei(Binzhou Medical College,Yantai 264003,P.R.China;Department of Radiology,Jiyang Public Hospital,Jinan 251400,P.R.China;Shandong Medical Imaging Research Institute Affiliated to Shandong University,Jinan 250021,P.R.China)

机构地区：[1]滨州医学院,山东烟台264003 [2]山东省济南市济阳区人民医院影像科,山东济南251400 [3]山东大学附属山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2020年第2期269-272,287,共5页Journal of Medical Imaging

摘　　要：目的通过对不同类型肾盂癌的肿瘤体积、CT平扫及增强各期CT值变化特点的定量分析,为肾盂癌的准确诊断提供定量客观依据。方法回顾性收集并经手术病理证实的22例肾盂癌患者及25例肾透明细胞癌(肾癌)的术前增强CT影像资料,采用ITK-SNAP软件获取病灶各期的体积、CT值等数据进行统计学对比分析。结果肾盂癌肿瘤小于肾癌肿瘤的体积(中位体积分别为5.87cm 3、8.11cm 3),P<0.05;平扫期肾盂癌肿瘤CT值大于肾癌〔平均值分别为(34.59±7.01)HU、(30.28±5.95)HU〕,P<0.05;皮质期、实质期肾盂癌肿瘤CT值(中位CT值分别为61.50HU、66.00HU)小于肾癌(81.00HU、74.00HU),P<0.05,分泌期两者CT值〔平均值分别为(58.07±11.60)HU、(65.53±15.11)HU〕,P>0.05。肿块浸润肾实质型肾盂癌的体积<侵犯肾盂的肾癌〔平均值分别为(25.22±34.85)cm 3、(119.44±69.28)cm 3〕,P<0.05,两者的平扫期、皮质期、实质期及分泌期肿瘤CT值差异均无统计学意义(P>0.05)。结论肾盂癌的体积显著小于肾癌,CT增强具有轻中度延迟强化的特征,可以为肾盂癌的准确诊断提供客观依据。Objective Through quantitative analysis of the volume of renal pelvic cancer(RPC)and the characteristic of change of CT values in enhanced CT,to provide objective evidence for the accurate diagnosis of RPC.Methods The preoperative enhanced CT scan data of 22 patients with RPC and 25 patients with clear cell renal cell carcinoma(ccRCC)confirmed by surgery and pathology were retrospectively collected.ITK-SNAP software was used to obtain the volume and CT values in each phase of enhanced CT for statistical comparison and analysis.Results The volume of RPC was smaller than the volume of ccRCC〔(take the median:5.87 cm 3,8.11 cm 3),P<0.05;the RPC’s CT value of tumor on scan was higher than the ccRCC’s〔take mean value:(34.59±7.01)HU,(30.28±5.95)HU〕,P<0.05;the RPC’s CT values of tumor on arterial and parenchymal phases〔take the median:61.50 HU,66.00 HU)were lower than the ccRCC’s(81.00 HU,74.00 HU),P<0.05;There was no significant difference in CT value between the two groups in secretory period〔take mean value:(58.07±11.60)HU,(65.53±15.11)HU〕,P>0.05.The volumes of infiltrative type renal pelvis carcinoma(ITRPC)was smaller than renal cancer that infiltrate the renal pelvis〔take mean value:(25.22±34.85)cm 3,(119.44±69.28)cm 3〕,P<0.05.There was no significant difference in CT values between the two groups in each phase(P>0.05).Conclusion The volume of RPC was smaller than the volume of ccRCC,and the CT value of RPC was characterized by mild to moderate delayed enhancement in CT enhancement.These can provide objective evidence for the accurate diagnosis of RPC.

关 键 词：肾盂癌 肿块浸润肾实质型肾盂癌 体层摄影术 X线计算机 肿瘤体积 

分 类 号：R373[医药卫生—病原生物学] R814.42[医药卫生—基础医学]