乏脂肪肾脏血管平滑肌脂肪瘤与肾透明细胞癌的CT表现及其临床意义  

CT findings and clinical significance of lipid poor renal angiomyolipoma and clear renal cell carcinoma

作　　者：韩亚峰 刘红 Han Yafeng;Liu Hong(Department ofImaging,Xi′an Daxing Hospital,Shaanxi 710016,China)

机构地区：[1]西安大兴医院影像科,710016

出　　处：《山西医药杂志》2021年第22期3119-3121,共3页Shanxi Medical Journal

摘　　要：目的分析乏脂肪肾脏血管平滑肌脂肪瘤(LPRAML)与肾透明细胞癌(CCRCC)的CT表现及其临床意义。方法回顾性选取2018年12月至2021年3月于我院影像科做检查的LPRAML患者及CCRCC患者为研究对象,并分别将其纳入LPRAML组(48例)、CCRCC组(32例)。2组均行CT检查,根据检查结果比较2组平扫、皮质期、髓质期、延迟期的病灶CT值及各期病灶CT值与对侧/同侧肾皮质CT值的比值;同时分析2组影像征象。结果LPRAML组平扫时病灶CT值高于CCRCC组(P<0.05),而2组皮质期、髓质期、延迟期的病灶CT值比较差异无统计学意义(P>0.05)。LPRAML组皮质期病灶CT值与对侧正常肾皮质CT值的比值低于CCRCC组(P<0.05),其余各期病灶CT值与对侧/同侧肾皮质CT值的比值比较差异无统计学意义(P>0.05)。LPRAML组病灶大小低于CCRCC组(P<0.05);LPRAML组单发、有囊变、有假包膜者占比分别为71%、8%、0,低于CCRCC组的100%、72%、9%(P<0.05);而2组钙化情况比较差异无统计学意义(P>0.05)。结论相较于LPRAML,CCRCC单发、囊变征象更为明显,皮质期相对强化程度较高,在两者的临床鉴别中,可联合肾脏病灶的CT表现及平扫、增强扫描皮质期的强化特点进行分析以更好地对LPRAML、ccRCC进行鉴别诊断。Objective To analyze the CT findings and clinical significance of lipid poor renal angiomyolipoma(LPRAML)and clear cell renal cell carcinoma(CCRCC).Methods Patients with LPRAML and CCRCC who were examined in the imaging department of our hospital from December 2018 to March 2021 were selected retrospectively,and they were divided into the LPRAML group(48 cases)and the CCRCC group(32 cases)respectively.CT examination was performed in both groups.According to the examination results,the CT values of lesions in plain scan,cortical stage,medullary stage and delayed stage were compared with the CT values of contralateral/ipsilateral renal cortex.At the same time,the imaging signs of the two groups were analyzed.Results The CT value of lesions in the LPRAML group were higher than that in the CCRCC group(P<0.05),but there was no significant difference in CT value of lesions in cortex,medulla and delayed stage between the two groups(P>0.05).The ratio of CT value of cortical lesions in the LPRAML group to that of contralateral normal renal cortex was lower than that in the CCRCC group(P<0.05),but there was no significant difference between CT value of other lesions in different stages and that of contralateral/ipsilateral renal cortex(P>0.05).The lesion size in the LPRAML group were lower than that in the CCRCC group(P<0.05).The rates of single lesion,cystic change and false capsule in LPRAML group were 71%,8%and 0,respectively,which were lower than those in CCRCC group(100%,72%and 9%,P<0.05).There was no significant difference in calcification between the two groups(P>0.05).Conclusion Compared with LPRAML,CCRCC had more obvious signs of single lesion and cystic change,and the degree of enhancement in cortical phase is higher.In the process of clinical identification,CT findings of renal lesions,enhancement characteristics of plain scan and enhanced scan in cortical phase can be combined to better differentiate LPRAML and CCRCC.

关 键 词：血管平滑肌脂肪瘤 肾透明细胞癌 电子计算机断层扫描 临床意义 

分 类 号：R737.11[医药卫生—肿瘤]