增强CT中病灶皮质衰减比在小肾肿瘤良恶性鉴别诊断中的应用研究  

Application in Differential Diagnosis of Benign and Malignant Small Kidney Tumors Using Ratio of Lesion to Cortex Attenuation for Contrast-enhanced CT

作　　者：周鹏 蒋瑾[2] 周光荣 ZHOU Peng;JIANG Jin;ZHOU Guang-rong(Department of Radiology,The Third People's Hospital of Xindu District,Chengdu 610504,Sichuan Province,China;Department of Radiology,Sichuan Provincial People's Hospital,Chengdu 610504,Sichuan Province,China;Department of Respiratory,The Third People's Hospital of Xindu District,Chengdu 610504,Sichuan Province,China)

机构地区：[1]成都市新都区第三人民医院放射科,四川成都610504 [2]四川省人民医院放射科,四川成都610072 [3]成都市新都区第三人民医院呼吸科,四川成都610504

出　　处：《中国CT和MRI杂志》2024年第4期116-118,共3页Chinese Journal of CT and MRI

摘　　要：目的提出全新参数—病灶皮质衰减比;并讨论其在增强CT中小肾肿瘤(病灶直径<4cm)的良恶性鉴别诊断中的临床应用价值。方法回顾性收集我院及四川省人民医院肾脏肿瘤患者的术前多期增强CT 70例。由两名有临床诊断经验的放射科医生采用双盲法分别记录肾脏肿瘤增强CT中的典型影像征象(边缘形态、强化类型、血管侵犯、肾周脂肪侵犯等)。并于肿瘤及邻近肾皮质区域分别选取感兴趣区域,计算病灶皮质衰减比。观察以上指标在小肾脏肿瘤不同良恶性亚型(肾嗜酸细胞腺瘤、平滑肌瘤、透明状细胞癌、乳头状细胞癌)间的表现。结果不同于恶性肾脏肿瘤,本研究中全部的良性肾脏肿瘤均呈现边缘清晰、无血管或肾周脂肪侵犯。肾嗜酸细胞腺瘤的病灶皮质衰减比与透明状细胞癌(P<0.05)和乳头状细胞癌(P<0.05)均有统计学差异。结论肾脏增强CT中病灶皮质衰减比可将有代表性的肾细胞癌(肾透明状细胞癌)与良性肿瘤(肾嗜酸细胞腺瘤)显著分层。具有临床应用价值。Objective To discuss the clinical application value in differential diagnosis of benign and malignant small kidney tumors(diameter<4cm)using ratio of lesion to cortex attenuation for contrast-enhanced CT.Methods This study retrospectively enrolled 70 preoperative multi-phase contrast-enhanced CT scans of patients with renal tumors in our hospital and Sichuan Provincial People's Hospital.Two experienced radiologists respectively recorded typical imaging features(edge morphology,enhancement type,vascular invasion,perirenal fat invasion,etc.).To obtain the ratio of lesion to cortex attenuation,they selected regions of interest from the tumor and adjacent renal cortex.Then we observe and compare the above parameters among different subtypes of small kidney tumors(oncocytoma,leiomyoma,renal clear cell carcinomas,renal papillary cell carcinomas).Results Unlike malignant kidney tumors,all benign kidney tumors in this study showed clear margins,no vascular or perirenal fat invasion.The ratio of lesion to cortex attenuation of oncocytoma was statistically different from that of renal clear cell carcinomas(P<0.05)and renal papillary cell carcinomas(P<0.05).Conclusion The ratio of lesion to cortex attenuation in renal contrast-enhanced CT can significantly classify representative renal cell carcinoma(renal clear cell carcinomas)and benign tumor(oncocytoma).It can be applied in clinical diagnosis.

关 键 词：肾脏肿瘤 多期增强CT 良恶性鉴别诊断 

分 类 号：R692[医药卫生—泌尿科学]