肾脏混合性上皮和间质肿瘤、囊性肾癌MSCT表现及其鉴别诊断  

MSCT Imaging Features of Mixed Epithelial and Stromal Tumor of Kidney,Cystic Renal Cell Carcinoma and Their Differential Diagnosis

作　　者：张巍[1] 王艳[1] ZHANG Wei;WANG Yan(Imaging Center,the First Affiliated Hospital of Henan University of Science and technology,Luoyang 471000,Henan Provincce,China)

机构地区：[1]河南科技大学第一附属医院影像中心,河南洛阳471000

出　　处：《中国CT和MRI杂志》2022年第4期115-117,共3页Chinese Journal of CT and MRI

基　　金：河南省科技攻关项目(201802320)。

摘　　要：目的分析肾脏混合性上皮和间质肿瘤(MESTK)、囊性肾癌(CRCC)多层螺旋CT(MSCT)影像表现及其鉴别诊断。方法选取本院2017年3月至2018年12月收治的8例MESTK和16例CRCC患者作为研究对象,分析MESTK、CRCC的MSCT表现及MSCT检查鉴别诊断MESTK、CRCC的灵敏性、特异性、准确性。结果MSCT检查诊断MESTK、CRCC的灵敏性为75.00%,特异性为81.25%,准确性为79.17%。8例MESTK患者均为单侧病变,均为囊实性病变,Bosniak分型:Ⅲ型6例,Ⅳ型2例。增强扫描显示分隔及壁延迟强化,囊性部分不强化,实性部分呈轻或中度强化。16例CRCC患者中,7例透明细胞癌囊变,边缘毛躁,Bosniak分型均为ⅡF型;增强扫描,囊壁及间隔呈轻中度强化;9例多房性透明细胞性肾细胞癌,Bosniak分型:Ⅲ型8例,Ⅳ型1例;增强扫描呈不同程度强化,实质期强化减弱。结论MSCT可有效显示MESTK、CRCC的影像学特点,通过分析肿瘤实性成分多少、间隔形态及增强方式可为有效鉴别MESTK、CRCC,为临床提供可靠的依据。Objective To analyze the multislice spiral CT(MSCT)imaging features of mixed epithelial and stromal tumor of kidney(MESTK),cystic renal cell carcinoma(CRCC)and the their differential diagnosis.Methods Eight patients with MESK and 16 patients with CRCC treated in our hospital from March 2017 to December 2018 were selected as the research objects,and the MSCT images of MESKK and CRCC and the sensitivity,specificity,and accuracy of MSCT examination in the differential diagnosis of MESKK and CRCC were analyzed.Results The sensitivity of MSCT in the diagnosis of MESKT and CRCC was 75.00%,the specificity was 81.5%,and the accuracy was 79.17%.The 8 patients with MESKK were unilateral lesions and all were cystic lesions.Bosniak classification:There were 6 cases with typeⅢand 2 cases with typeⅣ.Enhanced scans showed delayed strengthening of the partitions and walls.The cystic part was not strengthened,and the solid part was lightly or moderately strengthened.In the 16 patients with CRCC,7 cases had cystic lesions of clear cell carcinoma.The edge was frizzy,and Bosniak classifications were all typeⅡF.Enhancement scans showed mild to moderate enhancement of the capsule wall and septum.There were 9 cases with multilocular clear cell renal cell carcinoma.Bosniak classification:There were 8 cases with typeⅢand 1 case with typeⅣ.Enhancement scans showed varying degrees of enhancement,and the enhancement weakened in the parenchymal phase.Conclusion MSCT can effectively display the imaging features of MESKK and CRCC.By analyzing the solid components of the tumor,the shape of the septum,and the enhancement method,it can effectively identify MESKT from CRCC,which provide a reliable basis for clinical practice.

关 键 词：肾脏混合型上皮和间质肿瘤 囊性肾癌 多层螺旋CT 鉴别诊断 

分 类 号：R692[医药卫生—泌尿科学] R445.3[医药卫生—外科学]