基于CT影像特征鉴别小肾嫌色细胞癌及小乏脂型肾血管平滑肌脂肪瘤  

Differentiation of Small Chromophobe Renal Cell Carcinoma and Small Fat-PoorRenal Angiomyolipoma Based on CT Imaging Features

作　　者：林杉莎 颜竹 杜佳衡 何晓鹏 LIN Shasha;YAN Zhu;DU Jiaheng;HE Xiaopeng(Department of Radiology,Affliated Hospital of Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院放射科,泸州646000

出　　处：《中国医学计算机成像杂志》2024年第4期464-468,共5页Chinese Computed Medical Imaging

基　　金：四川省卫健委普及应用项目(20PJ129);西南医科大学附属医院博士基金(19080)。

摘　　要：目的:探讨小肾嫌色细胞癌(CRCC)及小乏脂型肾血管平滑肌脂肪瘤(fpAML)的CT影像学特征及其鉴别诊断要点。方法:回顾性纳入经手术病理证实的小fpAML(n=20)及小CRCC(n=26)患者的临床及影像资料,所有患者均接受CT平扫及增强检查。对2组患者的影像学特征进行分类整理,并进行统计学分析,对组间存在统计学差异的指标采用受试者工作特征(ROC)曲线法分析其鉴别小CRCC和小fpAML的价值。结果:20例小fpAML及26例小CRCC的肿瘤主体生长位置、平扫期CT值、假包膜、“冰淇凌蛋筒征”等特征均具有统计学差异,且平扫期CT值ROC曲线下面积最大为0.823,当平扫期CT值选择为39 HU时,鉴别小fpAML和小CRCC的灵敏度为85%,特异度为77%。2组病例增强扫描的强化程度及强化方式均无统计学差异,皮质期均以明显强化为主,且2组中大多数病例均表现为持续强化。结论:小fpAML和小CRCC在CT图像上平扫期CT值、肿瘤主体生长位置、“冰淇凌蛋筒征”及假包膜等特点对两者的鉴别诊断具有重要价值,再结合患者的性别、年龄等特点综合分析能在一定程度上提高其术前诊断准确率。Purpose:To investigate the CT imaging features of small chromophobe renal cell carcinoma(CRCC)and samll fat-poor angiomyolipoma(fpAML),along with the essential points for differential diagnosis.Methods:A retrospective review was conducted on clinical and imaging data of patients with small fpAML(n=20)and small CRCC(n=26)confirmed by surgical pathology.All patients underwent CT plain scan and enhanced examination.The imaging features of the two groups of patients were classified and summarized,followed by statistical analysis.For indicators showing statistically significant differences between the two groups,the value of distinguishing small CRCC from small fpAML was analyzed using receiver operating characteristic(ROC)curve method.Results:The tumor location,plain CT value,pseudocapsule,and"icecream cone sign"of 20 cases of small fpAML and 26 cases of small CRCC all showed statistically significant differences.The area under the ROC curve of the plain CT value was maximum at 0.823.When the plain CT value was selected as 39 HU,the sensitivity for distinguishing between small fpAML and small CRCC was 85%,with a specificity of 77%.The degree and pattern of enhancement in the enhanced CT scans of the two groups of cases showed no statistically significant differences.Most cases in both groups exhibited predominant cortical phase enhancement,with the majority showing sustained enhancement.

关 键 词：乏脂肪肾血管平滑肌脂肪瘤 肾嫌色细胞癌 计算机体层成像 肾脏肿瘤 

分 类 号：R445.3[医药卫生—影像医学与核医学]