多层螺旋CT增强扫描对不同亚型肾癌的鉴别诊断价值  

Value of enhanced multi-slice spiral CT in differential diagnosis of different subtypes of renal carcinoma

作　　者：张欣欣 郏立志[1] 邵焕军[2] 程刚[3] Zhang Xinxin;Jia Lizhi;Shao Huanjun;Cheng Gang(Imaging Center,Bozhou People′s Hospital,Bozhou 236800,China;Department of Urology,Bozhou People′s Hospital,Bozhou 236800,China;Department of Oncology,Bozhou People′s Hospital,Bozhou 236800,China)

机构地区：[1]亳州市人民医院影像中心,亳州236800 [2]亳州市人民医院泌尿外科,亳州236800 [3]亳州市人民医院肿瘤科,亳州236800

出　　处：《国际泌尿系统杂志》2024年第4期645-648,共4页International Journal of Urology and Nephrology

基　　金：安徽省亳州市科技重大专项项目(bzzd2020012)。

摘　　要：目的研究不同亚型肾癌鉴别诊断中多层螺旋CT增强扫描的应用价值。方法回顾性分析2018年6月至2023年6月入院的100例肾癌患者的临床资料,均经手术病理检查确诊,其中嫌色细胞癌23例,乳头状细胞癌31例,透明细胞癌46例。所有患者均于手术之前接受肾脏CT增强扫描检查,观察并分析其CT影像学特点,通过CT分型标准确定肾癌亚型,对比术后病理分型结果与CT分型结果的一致性,同时测定并比较各个亚型肾癌患者不同扫描期的CT值。结果以手术病理分型为诊断金标准,CT诊断嫌色细胞癌的准确率为91.30%(21/23)、诊断乳头状细胞癌的准确率为74.19%(23/31)、诊断透明细胞癌的准确率为93.48%(43/46)、整体诊断的准确率为87.00%(87/100),CT诊断方式与手术病理诊断方式的检测一致性较高(Kappa=0.804)。各亚型肾癌者的肾盂受压情况、边界清晰情况、直径、轮廓突出及分叶情况比较,差异均无统计学意义(均P>0.05);与嫌色细胞癌、乳头状细胞癌患者比较,透明细胞癌患者的非均质强化、坏死囊变、假包膜征例数更高,差异均有统计学意义(均P<0.05);与嫌色细胞癌、透明细胞癌患者比较,乳头状细胞癌患者的肿瘤钙化例数更高(均P<0.05)。与嫌色细胞癌、透明细胞癌患者比较,乳头状细胞癌患者的平扫期CT值更高(均P<0.05);与嫌色细胞癌、乳头状细胞癌患者比较,透明细胞癌患者的肾盂期、髓质期、皮质期CT值更高,差异均有统计学意义(均P<0.05)。结论嫌色细胞癌、乳头状及透明细胞癌患者的CT征象不尽相同,各亚型肾癌鉴别诊断中多层螺旋CT增强扫描具有重要价值。Objective To study the value of multi-slice spiral CT enhanced scanning in differential diagnosis of different subtypes of renal carcinoma.Methods From June 2018 to June 2023,100 patients with renal carcinoma admitted to hospital were retrospectively selected.All patients were confirmed by surgical pathological examination,including 23 chromophobe cell carcinoma,31 papillary cell carcinoma and 46 clear cell carcinoma.All patients received enhanced renal CT scan before operation,and the CT imaging characteristics were observed and analyzed.The renal cancer subtypes were determined by CT classification criteria.The consistency between postoperative pathological classification results and CT classification results was compared,and the CT values of patients with different subtypes were measured and compared at different scanning periods.Results The accuracy of CT in the diagnosis of chromophobe cell carcinoma was 91.30%(21/23),papillary cell carcinoma was 74.19%(23/31),clear cell carcinoma was 93.48%(43/46),and the overall diagnosis accuracy was 87.00%(87/100).There was a high consistency between CT diagnosis and pathologic diagnosis(Kappa=0.804).There were no significant differences in renal pelvis compression,clear boundary,diameter,contour protrusion and lobe segmentation among different subtypes of renal carcinoma(all P>0.05).Compared with the patients with chromophobe and papillary cell carcinoma,the number of heterogeneous enhancement,necrotic cyst change and false envelope signs in clear cell carcinoma patients was higher,and the difference was significant(all P<0.05).Compared with chromophobe and clear cell carcinoma,the number of tumor calcification cases in papillary cell carcinoma patients was higher,and the difference was significant(all P<0.05).Compared with the patients with chromophobe cell carcinoma and clear cell carcinoma,the CT value of papillary cell carcinoma in plain scan period was higher,and the difference was significant(all P<0.05).Compared with chromophobe cell carcinoma and papillary cell

关 键 词：肾肿瘤 多层螺旋CT 外科手术 

分 类 号：R737.11[医药卫生—肿瘤]