肾透明细胞癌CT扫描检查参数与其Fuhrman病理分级的关系研究  被引量:6

Study on the relationship between the examination parameters of CT scan and Fuhrman pathological grading in renal clear cell carcinoma

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作  者:高勇 叶名楠 宋东虎 胡德军 GAO Yong;YE Ming-nan;SONG Dong-hu(Department of Medical Imaging,Xuancheng City Central Hospital,Xuancheng 242000,China;不详)

机构地区:[1]宣城市中心医院影像科,安徽宣城242000 [2]宣城市中心医院泌尿科,安徽宣城242000

出  处:《中国医学装备》2021年第10期24-28,共5页China Medical Equipment

摘  要:目的:探讨肿瘤直径<7 cm的肾透明细胞癌CT扫描检查参数与Fuhrman病理核分级的关系。方法:选取医院收治的62例肾透明细胞癌患者并将其纳入观察组,同时选取35例乏脂肪血管平滑肌脂肪瘤患者并将其纳入对照组,比较两组患者CT影像特征,以及不同Fuhrman病理核分级肾透明细胞癌CT影像特征。结果:观察组患者病灶钙化、坏死、囊变、假包膜和造影剂快进快出比例分别为48.39%、69.35%、77.42%、37.10%和56.45%,明显高于对照组,差异有统计学意义(x^(2)=11.280,x^(2)=21.818,x^(2)=15.549,x^(2)=7.338,x^(2)=5.618;P<0.05);观察组病灶平扫CT值为(40.03±7.82)HU,明显低于对照组,差异有统计学意义(t=-4.477,P<0.05),而实质期CT值为(126.69±30.42)HU,明显高于对照组,差异有统计学意义(t=3.345,P<0.05)。观察组Fuhrman病理分级高级别(Ⅲ~Ⅳ级)病灶钙化、坏死、囊变、假包膜及不均匀强化比例分别为68.00%、84.00%、96.00%和64.00%,明显高于低级别(Ⅰ~Ⅱ级),差异有统计学意义(x^(2)=6.452,x^(2)=4.227,x^(2)=8.273,x^(2)=12.994;P<0.05);观察组高级别病灶皮髓期、实质期CT值为(112.72±27.82)HU和(116.55±22.21)HU,明显低于低级别,差异有统计学意义(t=2.598,t=2.707;P<0.05)。Logistic回归分析中病灶坏死、囊变、假包膜、皮髓期CT值和实质期CT值是Fuhrman病理核分级的影响因素(OR=1.542,OR=1.774,OR=1.465,OR=0.587,OR=0.542;P<0.05)。病灶坏死、囊变、假包膜、皮髓期CT值和实质期CT值联合诊断高级别的受试者工作特征(ROC)曲线下面积(AUC)为0.914,灵敏度和特异度分别为82.00%和68.00%。结论:在<7 cm肾透明细胞癌中,CT影像特征的病灶坏死、囊变、假包膜、皮髓期及实质期CT值与Fuhrman病理核分级中具有一定价值。Objective:To investigate the relationship between the examination parameters of computed tomography(CT)scan and Fuhrman pathological grading of renal clear cell carcinoma which was less than 7 cm.Methods:62 patients with renal clear cell carcinoma who admitted to hospital were divided into observation group,and 35 patients with angiomyolipoma were divided into control group.And the characteristics of CT images between two groups were compared,and the characteristics of CT images of renal clear cell carcinoma between different Fuhrman pathological grading also were compared.Results:The proportions of calcification,necrosis,cystic change and pseudocapsule of the lesions,and that of the fast in fast out of contrast agent in observation group were 48.39%,69.35%,77.42%,37.10%and 56.45%,respectively,which were significantly higher than those in control group(x^(2)=11.280,x^(2)=21.818,x^(2)=15.549,x^(2)=7.338,x^(2)=5.618,P<0.05).The CT value of plain scan of observation group was(40.03±7.82)HU,which was significantly lower than that of control group(t=-4.477,P<0.05),while the CT value of parenchyma phase of observation group was(126.69±30.42)HU,which was significantly higher than that of control group(t=3.345,P<0.05).In the observation group,the proportions of calcification,necrosis,cystic change,pseudocapsule and heterogeneous enhancement of high-grades(Ⅲ-Ⅳgrades)as Fuhrman pathological grading were 68.00%,84.00%,96.00%and 64.00%,respectively,which were significantly higher than those of low grades(I-II grades)(x^(2)=6.452,x^(2)=4.227,x^(2)=8.273 and,x^(2)=12.994,P<0.05).In the observation group,the CT values of medullary phase and parenchymal phase of lesions at high grades(Ⅲ-Ⅳgrades)were(112.72±27.82)HU and(116.55±22.21)HU,respectively,which were significantly lower than those of low grades(t=2.598,t=2.707,P<0.05).The results of Logistic regression analysis showed that necrosis,cystic change and pseudocapsule of lesion,and CT value in medullary phase and CT value in parenchymal phase were the influence fa

关 键 词:肾透明细胞癌 CT扫描 Fuhrman病理核分级 LOGISTIC回归分析 

分 类 号:R737.11[医药卫生—肿瘤]

 

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