采用CT三期增强扫描评估肾透明细胞癌术前T分期的准确性研究  

Accuracy of CT Three-Phase Enhanced Scan in Evaluating Preoperative T Stage of Renal Clear Cell Carcinoma

作　　者：王志芳[1] WANG Zhi-fang(Department of Radiology,Puyang Oilfield General Hospital,Puyang 457001,Henan Province,China)

机构地区：[1]濮阳市油田总医院放射科,河南濮阳457001

出　　处：《中国CT和MRI杂志》2022年第3期105-107,共3页Chinese Journal of CT and MRI

摘　　要：目的分析CT三期增强扫描评估肾透明细胞癌术前T分期的准确性。方法收集本院2017年3月至2019年10月收治的177例肾透明细胞癌患者临床资料,患者均进行CT三期增强扫描,以病理检查结果为参照,计算CT对肾透明细胞癌患者T分期准确性。结果经手术后病理检查,97例肾透明细胞癌患者T_(1a)期45例,T_(1b)期22例,T_(2a)期27例,T_(2b)期12例,T_(3a)期48例,T_(3b)期9例,T_(3c)期8例,T_(4)期6例。CT检查对肾透明细胞癌T_(1a)、T_(3b)、T_(3c)、T_(4)分期均无高估、低估情况,T_(1b)期高估4例,T_(2a)期3例,T_(2b)期3例,T_(3a)期高估1例低估9例,经Kappa检验K=0.845提示两者一致性好(P>0.75)。在本研究中84.45%(150/177)患者肿瘤部位位于肾上极,肿瘤直径在5~15cm,轮廓欠规整,大部分边缘较清晰,当肿瘤较大突破肾被膜时可致肿瘤边缘模糊不清。结论CT三期增强扫描评估肾透明细胞癌术前T分期的准确性较高,但对T_(3a)期判断尚存局限性在临床实践中需要引起足够重视。Objective To analyze the accuracy of CT three-phase enhanced scan in evaluating preoperative T stage of renal clear cell carcinoma.Methods The clinical data of 177 patients with renal clear cell carcinoma admitted in our hospital from March 2017 to October 2019 were collected.All patients underwent a three-phase enhanced CT scan.Based on the results of pathological examination,accuracy of CT in the diagnosis of T stage of patients with renal clear cell carcinoma was calculated.Results Postoperative pathological examination showed that among 97 patients with clear cell renal cell carcinoma,45 cases were in T_(1a) stage,22 cases were in T_(1b) stage,27 cases were in T_(2a) stage,12 cases were in T_(2b) stage,48 cases were in T_(3a) stage,9 cases were in T_(3b) stage,8 cases were in T_(3c) stage,6 cases were in T_(4) stage stage.CT examination did not overestimate or underestimate T_(1a),T_(3b),T_(3c),and T_(4) stages of renal clear cell carcinoma.CT examination overestimated T_(1b) stage in 4 cases,T2a stage in 3 cases,T_(2b) stage in 3 cases,and overestimated T3a stage in 1 case,and underestimated T_(3a) stage in 9 cases.Kappa test K=0.845 indicates that the them are in good agreement(P>0.75).In this study,the tumors of 84.45%(150/177)patients were located in the upper pole of the kidney.The diameter of the tumor was 5 to 15 cm.The outline was irregular and most of the edges were clear.When the tumor was large and brok through the renal capsule,it can cause the tumor edge to be blurred.Conclusion The accuracy of the three-phase enhanced CT scan to evaluate the preoperative T stage of renal clear cell carcinoma is higher.However,there are still limitations in the judgment of T_(3a) stage,which needs to be paid enough attention in clinical practice.

关 键 词：CT 三期增强 肾透明细胞 癌术前T分期 准确性 

分 类 号：R445.3[医药卫生—影像医学与核医学]