多模态影像技术对不同亚型肾癌及其病理学分级的诊断效能  

The Diagnostic Efficacy of Multimodal Imaging in Different Subtypes of Renal Cell Carcinoma and Its Pathological Grading

作　　者：武宝华 吴博云 邵亚军[1] 郑星星 WU Bao-hua;WU Bo-yun;SHAO Ya-jun;ZHENG Xing-xing(Medical Imaging Department,Baoji Central Hospital,Baoji 721008,Shaanxi Province,China)

机构地区：[1]宝鸡市中心医院医学影像科,陕西宝鸡721008

出　　处：《中国CT和MRI杂志》2024年第10期111-113,共3页Chinese Journal of CT and MRI

基　　金：多模态影像在肾癌术前定性及术前分期中的临床应用研究价值研究(2021-019);“双低”技术冠状动脉CT造影在冠心病中的应用价值与研究(2021-020);Revolution CT在血管联合扫描中的临床应用研究(2021-022);能谱CT联合影像组学预测韭小细胞肺癌Ki67的表达研究(2021-023)。

摘　　要：目的 多模态影像技术对不同亚型肾癌及其病理学分级的诊断效能分析。方法选取2021年1月~2023年1月经B超初检为可疑肾细胞癌的90例患者,开展多模态CT和MR检查,以病理学检查结果作为诊断金标准,分析单独CT、MR检查与多模态CT、MR技术在可疑肾细胞癌良恶性质的诊断效能,并分析不同亚型、不同组织病理学分级、不同TNM分期肾癌与多模态影像学特征的相关性。结果(1)多模态影像技术在肾脏良恶性病变诊断中AUC>0.85,预测价值较强,灵敏度、特异度分别为98.61%、94.44%。(2)肾癌亚型与强化程度、囊性坏死呈正相关性(r=0.865、0.841,P<0.05)。(3)肾癌组织病理学分级与病灶直径、边界不清、明显强化、出血、囊性坏死呈正相关性(r=0.832、0.828、0.826、0.823、0.812,P<0.05)。(4)不同亚型ADC值、rADC值比较无差异(P>0.05);与病理学Ⅰ+Ⅱ级比较,Ⅲ级ADC值、rADC值较高(P<0.05)。结论不同亚型、组织病理学分级及TNM分期与多模态影像学强化程度、囊性坏死等特征存在一定关联,且多模态影像学技术在肾癌性质预测价值较高,有利于进一步提升肾癌疾病性质、亚型、分级和分期的诊断准确率。Objective To analyze the efficacy of multimodal imaging techniques for the diagnosis of different subtypes of kidney cancer and their pathology classification.Methods From January 2021 to January2023,90 patients with suspected renal cell ca rcinoma diagnosed by ultrasonography were exa mined by multimodality CT and MR.To analyze the diagnostic efficacy of CT and MR alone and multimodality CT and MR techniques in suspected renal cell ca rcinoma.To analyze the relationship between multimodality imaging characteristics and different subtypes,histopathologic grades,and TNM stages of renal cell carcinoma.Results(1) Multimodal imaging in the diagnosis of benign and malignant renal lesions 0.85,the predictive value is strong,with sensitivity and specificity of 98.61% and 94.44% respectively.(2) RCC subtypes were positively correlated with the degree of enhancement and cystic necrosis(r=0.865,0.841,P<0.05).(3) Renal cancer tissue pathology grade was positively correlated with lesion diameter,unclear boundary,apparent intensification,bleeding,and cystic necrosis(r=0.832,0.828,0.826,0.823,0.812,P<0.05).(4) There was no difference in ADC value and rADC value among different subtypes(P>0.05).The ADC and rADC of grade iii were higher than those of grade I+ii(P<0.05).Conclusion Different subtypes,histological grading and TNM staging a re related to the enhancement degree of multimodality imaging.Cystic necrosis and other features are related,and multimodal imaging technology has a high value in predicting the nature of kidney cancer,which is conducive to further improving the diagnostic accu racy of the nature,subtype,grade and stage of kidney ca rcinoma.

关 键 词：多模态影像技术 肾癌 亚型 影像学特征 病理学相关性 诊断效能 

分 类 号：R692[医药卫生—泌尿科学]