直径≤4cm非均质性AML与肾透明细胞癌的MSCT表现及鉴别诊断  

MSCT Characteristics of Patients with Heterogeneous AML with Diameter≤4cm and Renal Clear Cell Carcinoma,and Their Differential Diagnosis Value

作　　者：沈远望 王婉 刘尼军 李新胜 周浩亮 SHEN Yuan-wang;WANG Wan;LIU Ni-jun;LI Xin-sheng;ZHOU Hao-liang(Department of Medical Imaging,Shaanxi Nuclear Industry 215 Hospital,Xianyang 712000,Shaanxi Province,China;Department of Neurology,Shaanxi Nuclear Industry 215 Hospital,Xianyang 712000,Shaanxi Province,China;Department of Medical Imaging,Weibei Central Hospital,Weinan 715100,Shaanxi Province,China)

机构地区：[1]陕西省核工业二一五医院医学影像科,陕西咸阳712000 [2]陕西省核工业二一五医院神经内科,陕西咸阳712000 [3]陕西省渭南市渭北中心医院医学影像科,陕西渭南715100

出　　处：《中国CT和MRI杂志》2022年第11期118-120,共3页Chinese Journal of CT and MRI

基　　金：陕西省重点研发计划(2018SF-136)。

摘　　要：目的旨在研究直径≤4cm非均质性AML与肾透明细胞癌的MSCT表现及鉴别诊断价值。方法回顾分析本院2016年1月至2019年2月收治的30例乏脂肪型AML患者和34例CCRCC患者的临床资料,所有患者均接受MSCT检查。对患者所得图像进行分析,对比乏脂肪型AML和CCRCC的各时期CT值差异。结果平扫时CCRCC病灶CT值低于乏脂肪型AML者,但在皮质期净强化值、实质期净强化值分高于乏脂肪型AML者(P﹤0.05),乏脂肪型AML,MSCT平扫:肿瘤大部分略高密度,有少量脂肪成份为小点状低密度;增强扫描动脉期明显均匀强化,实质期减弱。CCRCC患者MSCT平扫图像呈稍低或等密度,伴出血时可夹杂稍高密度;增强时明显强化及强化形式表现为“快进快出”。结论平扫密度、平均性,有无楔形征、假包膜,增强后净强化值等MSCT表现在直径≤4cm非均质性AML与肾透明细胞癌的鉴别诊断中有重要参考价值。Objective To study the MSCT characteristics of patients with heterogeneous AML with diameter≤4 cm and renal clear cell carcinoma,and their differential diagnosis value.Methods The clinical data of 30patients with AML with minimal fat and 34 patients with CCRCC admitted to our hospital from January 2017 to February 2019 were retrospectively analyzed.All patients underwent MSCT.The images of patients were analyzed to compare the differences in CT values between the AML with minimal fat and CCRCC in each period.Results The CT value of patients with CCRCC was lower than that of patients with AML with minimal fat,but the net enhancement value in the cortical phase and in the nephrographic phase were higher(P﹤0.05).The MSCT plain scan of AML with minimal fat showed that most of the tumor showed a slightly high density,and a small amount of fat showed small dot-like low density.The enhanced scanning in arterial phase showed a marked uniform enhancement and it weakened in nephrographic phase.The images of patients with CCRCC in MSCT scan in showed a slightly lower or equal density,and when patients were accompanied with bleeding,it can be mixed with a slightly higher density.When enhanced,it showed a significant enhancement and the enhanced form appears as"fast forward and fast out."Conclusion The density and homogeneity of plain scan,the presence or absence of wedge-shaped signs,pseudo-envelopes,and net enhancement values after enhancement have important reference value in the differential diagnosis of heterogeneous AML with diameter≤4cm and renal clear cell carcinoma.

关 键 词：直径≤4cm 非均质性AML 肾透明细胞癌 MSCT表现 鉴别诊断 

分 类 号：R322.61[医药卫生—人体解剖和组织胚胎学]