MRI对多房囊性肾细胞癌与囊性肾瘤的诊断价值  

Clinical value of MRI in the diagnosis of multilocular cystic renal cell carcinoma and cystic nephroma

作　　者：葛晓雪 韩婷婷[1] 樊晓雪[1] 于兵[1] GE Xiaoxue;HAN Tingting;FAN Xiaoxue;YU Bing(Department of Radiology,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院放射科,沈阳110004

出　　处：《磁共振成像》2021年第4期30-34,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:81871336)。

摘　　要：目的结合2019版Bosniak分级,分析多房囊性肾细胞癌(multilocular cystic renal cell carcinoma,MCRCC)和囊性肾瘤(cystic nephroma,CN)的MRI特征,探讨其诊断价值。材料和方法回顾性分析我院2015年1月至2020年12月经病理确诊的24例MCRCC和16例CN患者的临床及MRI表现,对两组样本进行χ^(2)检验或独立样本t检验,采用ROC曲线分析其影像特征,并对病变进行Bosniak分级。结果24例MCRCC病变大部分外凸性生长,囊壁及分隔多不规则增厚,平均厚度为(3.87±1.41)mm,12例伴有附壁结节,平均结节直径为(8.47±1.31)mm,皮质期明显强化。CN病变的囊壁及分隔厚度较薄且均匀,均值为(2.17±0.63)mm,只有3例可见附壁结节。MCRCC和CN在患病年龄、病变是否外凸生长、囊壁及分隔厚度和附壁结节大小上的差异均有统计学意义(P<0.05),且当囊壁及分隔厚度大于3.25 mm,附壁结节直径大于3.7 mm时,可作为诊断MCRCC的最佳临界值。结论MRI对MCRCC和CN的诊断有一定价值,尤其是囊壁及分隔厚度和附壁结节的大小有助于两者的鉴别。Objective:To analyze the clinical and MRI imaging features of multilocular cystic renal cell carcinoma(MCRCC)and cystic nephroma(CN)according to Bosniak classification version 2019,and to evaluate the diagnostic value.Materials and Methods:MRI images of 24 MCRCC and 16 CN which were confirmed by pathologic examination from January 2015 to December 2020 were retrospectively reviewed.We performedχ^(2)test or independent t-test on the two groups of samples,used ROC curve to analyze their image characteristics,and graded the lesions according to Bosniak classification.Results:Most cases of MCRCC showed protruding growth pattern and irregular thickening of cyst wall and septum,with thickness averaged(3.87±1.41)mm.Mural nodules were found in12 cases with diameter averaged(8.47±1.31)mm.Obvious enhancement were found in cortical phase.The thickness of cyst wall and septum in CN lesions were thin and uniform,with the average of(2.17±0.63)mm.Mural nodule was seen in 3 case.We detected significant statistical differences between MCRCC and CN in the age,protruding growth pattern,septal and wall thickness and the sizes of mural nodules(P<0.05).When the thickness of cyst wall and septum was more than 3.25 mm and the diameter of mural nodules was larger than 3.7 mm,they could be used as the best critical value for the diagnosis of MCRCC.Conclusions:MRI is certain value in the diagnosis of MCRCC and CN.Especially the septal and wall thickness and the size of mural nodules are helpful to distinguish between MCRCC and CN.

关 键 词：多房囊性肾细胞癌 囊性肾瘤 磁共振成像 BOSNIAK分级 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.11[医药卫生—诊断学]