增强CT联合MRI检查对肾透明细胞癌的预后预测价值分析及与临床特征的相关性  

Analysis of predictive value of enhanced CT combined with MRI examination on prognosis of clear cell renal cell carcinoma and its correlation with clinical features

作　　者：徐昆峰 邱晓辉[1] 刘艺超[1] 董修明[1] Xu Kunfeng;Qiu Xiaohui;Liu Yichao;Dong Xiuming(Imaging Center,The People′s Hospital of Bozhou,Anhui Province,Bozhou 236800,China)

机构地区：[1]亳州市人民医院影像中心,亳州236800

出　　处：《中国医学装备》2025年第1期30-35,共6页China Medical Equipment

基　　金：安徽省卫健委科研计划项目(201920135)。

摘　　要：目的:探讨增强CT联合MRI检查对肾透明细胞癌的预后预测价值及与临床特征的相关性。方法:回顾性选取2019年3月至2023年5月亳州市人民医院收治的80例疑似肾透明细胞癌(ccRCC)患者的增强CT和MRI术后随访资料,依据疾病进展情况将其分为病情进展组(24例)和无进展组(56例)。通过病史采集和体检、增强CT、MRI、实验室检查、病理检查等相关检查诊断病情进展,根据患者临床和影像图像信息将年龄、性别、肿瘤直径、有无癌栓、肿瘤位置以及手术方式进行单因素logistic回归分析,确定独立预测因子。采用受试者工作特征(ROC)曲线分析增强CT联合MRI检查对ccRCC的预后预测价值。采用Pearson线性相关性分析增强CT联合MRI检查结果与预后的相关性。结果:根据随访结果,病情进展组患者皮质期CT值、髓质期CT值及表观弥散系数(ADC)均明显小于无进展组,差异有统计学意义(t=10.610、4.697、2.901,P<0.05),弥散系数(K)明显大于无进展组,差异有统计学意义(t=6.375,P<0.05),两组扩散率(D)比较差异无统计学意义(P>0.05);增强CT、MRI单独检查及联合检查预测ccRCC预后的ROC曲线下面积(AUC)均>0.5,提示两种检查对预测ccRCC预后均具有一定的价值,且联合检查的AUC最高,为0.940,提示联合检查对预测ccRCC预后的价值最高;两组性别、手术方式、癌栓及肿瘤位置例数比较差异均无统计学意义(P>0.05),病情进展组年龄、肿瘤直径均明显大于无进展组,差异有统计学意义(t=4.292、3.219,P<0.05);logistic回归分析显示,患者年龄、肿瘤直径均是ccRCC预后的独立影响因素(HR=2.167、0.689,P<0.05);Pearson相关性分析结果显示,增强CT检查与预后均存在负相关性(r=-0.65,P<0.05),MRI检查与预后均存在正相关性(r=0.72,P<0.05),增强CT检查结果与MRI检查结果之间均存在负相关性(r=-0.58,P<0.05)。结论:增强CT联合MRI检查对肾透明细胞癌的预后预测高于单项�Objective:To investigate the predictive value of enhanced computed tomography(CT)combined with magnetic resonance imaging(MRI)examination on prognosis of clear cell renal cell carcinoma(ccRCC)and its correlation with clinical features.Methods:The postoperative follow-up data of enhanced CT and MRI of 80 patients with suspected(ccRCC)who admitted to Bozhou People's Hospital from March 2019 to May 2023 were selected,and they were divided into disease progression group(24 cases)and disease progression-free group(56 cases)according to the condition of disease progression.The disease progression of them were diagnosed through relevant examinations(collection of disease history,physical examination,enhanced CT,MRI,laboratory examination,pathological examination and so on).According to the information of clinical imaging,the age,gender,tumor diameter,with or without tumor thrombus,the location of tumor and surgical method were used to conduct single factor logistic regression analysis,so as to confirm independent predictors.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of enhanced CT combined with MRI to the prognosis of ccRCC.The Pearson linear correlation was adopted to analyze the correlation between the results of enhanced CT combined with MRI and prognosis.Results:Based on the results of the follow-up study,CT value of cortex phase,CT value of medullary phase and apparent dispersion coefficient(ADC)in the disease progression group were significantly smaller than those in the disease progression-free group,and the differences of them between two groups were statistically significant(t=10.610,4.697,2.901,P<0.05),respectively.The diffusion coefficient(K value)of disease progression group was significantly larger than that of disease progression-free group,and there was significant difference between the two groups(t=6.375,P<0.05),while there was no significant in diffusion rate(D)between the two groups(P>0.05).The area under curve(AUC)values of ROC curve of single enhanced CT exa

关 键 词：增强CT 磁共振成像(MRI) 肾透明细胞癌(ccRCC) 预后预测 临床特征 

分 类 号：R816[医药卫生—放射医学] R445.2[医药卫生—临床医学] R737.11