多层螺旋CT对肾透明细胞癌、乏脂性肾血管平滑肌脂肪瘤的鉴别诊断价值  

Value of Multi-slice Spiral CT in the Differential Diagnosis of Renal Clear Cell Carcinoma and Lipoid Renal Angiomyolipoma

作　　者：杨蕾[1] 樊小玲 YANG Lei;FAN Xiao-ling(Department of Medical Imaging,Baoji People's Hospital,Baoji Shaanxi 721000)

机构地区：[1]宝鸡市人民医院医学影像科,陕西宝鸡721000

出　　处：《医学临床研究》2023年第3期363-366,共4页Journal of Clinical Research

摘　　要：【目的】探讨多层螺旋CT(MSCT)对肾透明细胞癌(ccRCC)、乏脂性肾血管平滑肌脂肪瘤(AMLmf)的鉴别诊断价值及其评估ccRCC患者Fuhrman分级的价值。【方法】28例ccRCC患者设为A组,27例AMLmf患者设为B组。对比两组患者MSCT检查的影像学征象(肿瘤大小及肿瘤是否钙化、囊变、出血、可见血管、多发病灶)、CT值(平扫、皮质期、髓质期及排泄期)及肿瘤强化模式(均匀强化、不均匀强化、主要周边及分隔强化)。比较A组不同Fuhrman分级患者的CT值(平扫、皮质期及髓质期)及假包膜情况。【结果】A组肿瘤直径明显大于B组(P<0.05);A组肿瘤囊变、多发病灶、肿瘤出血患者比例明显高于B组(P<0.05);两组肿瘤钙化、肿瘤可见血管患者比例比较,差异无统计学意义(P>0.05)。A组平扫CT值显著低于B组(P<0.05);A组皮质期CT值显著高于B组(P<0.05);两组髓质期、排泄期CT值比较,差异无统计学意义(P>0.05);A组肿瘤不均匀强化患者比例明显高于B组(P<0.05)。Fuhrman分级Ⅰ~Ⅱ级患者皮质期、髓质期CT值显著高于Ⅲ~Ⅳ级患者(P<0.05);两者平扫CT值比较,差异无统计学意义(P>0.05);Ⅰ~Ⅱ级患者假包膜完整率显著高于Ⅲ~Ⅳ级患者(P<0.05)。【结论】ccRCC与AMLmf两者的MSCT影像学特征、肿瘤平扫CT值及肿瘤强化模式具有差异,同时皮质期、髓质期CT值与假包膜情况可对ccRCC患者的Fuhrman分级进行评估。【Objective】To explore the value of multi-slice spiral CT(MSCT)in the differential diagnosis of renal clear cell carcinoma(ccRCC)and lipoid renal angiomyolipoma(AMLmf)and to analyze the value of MSCT in evaluating the Fuhrman classification of ccRCC patients.【Methods】A total of 28 patients with ccRCC were divided into group A and 27 patients with AMLmf were divided into group B.The imaging signs(tumor size,tumor calcification,cystic change,hemorrhage,visible blood vessels and multiple lesions),CT values(plain scan,cortical phase,medullary phase and excretory phase)and tumor enhancement patterns(homogeneous enhancement,heterogeneous enhancement,main peripheral and septal enhancement)of MSCT were compared between the two groups.The CT value(plain scan,cortical phase and medullary phase)and pseudocapsule of patients with different Fuhrman grades in the group A were compared.【Results】The diameter of tumor in the group A was significantly larger than that in the group B(P<0.05);The proportion of patients with cystic change,multiple lesions and tumor hemorrhage in the group A was significantly higher than that in the group B(P<0.05);There was no significant difference between the two groups in the proportion of patients with tumor calcification and visible blood vessels(P>0.05).The CT value of plain scan in the group A was significantly lower than that in the group B(P<0.05);The CT value of cortical phase in the group A was significantly higher than that in the group B(P<0.05);There was no significant difference in CT values between the two groups in medullary phase and excretory phase(P>0.05);The proportion of patients with heterogeneous tumor enhancement in the group A was significantly higher than that in the group B(P<0.05).The CT values of cortex and medulla in patients with Fuhrman gradeⅠ~Ⅱwere significantly higher than those in patients with gradeⅢ~Ⅳ(P<0.05);There was no significant difference between the two CT values(P>0.05);The rate of pseudocapsule integrity in patients with gradeⅠtoⅡw

关 键 词：腺癌 透明细胞 肾肿瘤 血管肌脂瘤 体层摄影术 螺旋计算机 

分 类 号：R737.11[医药卫生—肿瘤]