小肾乏脂肪血管平滑肌脂肪瘤和小肾嗜酸细胞腺瘤的CT鉴别诊断  

Small angiomyolipoma with minimal fat:differentiation from small renal oncocytoma by multidetector CT

作　　者：陈杰[1] 王姗姗[1] 王艳[1] CHEN Jie;WANG Shanshan;WANG Yan(Department of Radiology and Medical Imaging, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, P.R.China)

机构地区：[1]新疆维吾尔自治区人民医院放射影像中心,新疆乌鲁木齐830001

出　　处：《医学影像学杂志》2021年第5期827-831,共5页Journal of Medical Imaging

基　　金：新疆维吾尔自治区自然科学基金(编号:2018D01C137)。

摘　　要：目的分析直径≤4 cm的肾乏脂肪血管平滑肌脂肪瘤(AMLmf)和肾嗜酸细胞腺瘤(RO)的影像资料,提高对二者的鉴别诊断水平。方法选取并分析经病理证实的AMLmf患者10例及RO患者17例的影像学资料。结果AMLmf与RO在形态、平扫密度、强化均匀程度、劈裂征方面差异有统计学意义(P均<0.05)。与RO相比,AMLmf更多的表现为非类圆形、平扫呈高密度、强化相对均匀及少见劈裂征。而在肿瘤囊变、假包膜、强化方式方面差异无统计学意义,但是结合强化方式、中央瘢痕及节段性增强反转等征象可以提高二者的鉴别。AMLmf各期强化程度均低于RO组,差异有统计学意义(P均<0.05)。ROC曲线分析肿瘤增强各期CT值、绝对强化CT值鉴别AMLmf与RO的能力,C3的曲线下面积最大,为0.929,阈值取0.45时,鉴别两组肿瘤的敏感度及特异度分别为82.35%、90.00%。结论直径≤4 cm的AMLmf肿瘤形态多表现为非类圆形,平扫CT值高于RO,各期增强程度均低于RO。进一步结合强化方式、中央瘢痕及节段性增强反转等征象可以提高二者的鉴别。Objective To analyze the imaging data of angiomyolipoma with minimal fat(AMLmf)and renal oncocytoma(RO)with a diameter≤4 cm so as to improve the differential diagnosis of the two.Methods The imaging data of 10 patients with AMLmf and 17 patients with RO were retrospectively analyzed.Results There were statistically significant differences in morphology,scanning density,uniformity of enhancement,and splitting signs between AMLmf and RO(all P<0.05).Compared with RO,AMLmf was more non-circular,high-density in scanning,relatively uniform strengthening,and rare cleavage signs.There were no significant differences in tumor cystic changes,pseudocapsules,and enhancement methods,but the combination of enhancement methods,central scars,and segmental enhanced inversion can improve the identification of the two.The enhancement degree of AMLmf in each period was lower than that in RO group,and the difference was statistically significant(all P<0.05).The ROC curve was used to analyze the ability of tumor enhancement CT value and absolute enhanced CT value to identify AMLmf and RO.The area under the C3 curve was the largest at 0.929.When the threshold value was 0.45,the sensitivity and specificity of the two groups of tumors were 82.35%,90.00%.Conclusion The AMLmf with a diameter of≤4 cm is mostly non-circular,and the CT value of plain scan is higher than that of RO,and the enhancement degree of each stage is lower than RO.Further combination of signs of enhancement,central scar,and segmental enhanced reversal can improve the identification of the two.

关 键 词：肾血管平滑肌脂肪瘤 肾嗜酸细胞腺瘤 体层摄影术 X线计算机 

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