多层螺旋CT征象对肾透明细胞癌侵袭性的评估价值分析  

Evaluation value of MSCT signs in invasiveness of clear cell renal cell carcinoma

作　　者：李佳[1] 冯硕[2] Li Jia;Feng Shuo(Department of Radiology,Guang’anmen Hospital South Campus,China Academy of Chinese Medical Sciences,Beijing 102618,China;Center for Evidence-Based Medicine,Guang’anmen Hospital South Campus,China Academy of Chinese Medical Sciences,Beijing 102618,China)

机构地区：[1]中国中医科学院广安门医院南区放射科,北京102618 [2]中国中医科学院广安门医院南区循证医学中心,北京102618

出　　处：《中国医刊》2025年第3期293-296,共4页Chinese Journal of Medicine

基　　金：北京市中医药科技发展资金项目(BJZYQN-2023-20)。

摘　　要：目的探讨多层螺旋CT(MSCT)征象对肾透明细胞癌(CCRCC)侵袭性的评估价值。方法选取2019年2月至2024年2月在中国中医科学院广安门医院南区接受诊断的94例CCRCC患者,根据病理结果分为侵袭组(n=31)和非侵袭组(n=63)。两组患者均接受MSCT检查,比较其一般资料、MSCT特征、MSCT平扫值、MSCT强化程度,采用受试者操作特征(ROC)曲线分析MSCT对CCRCC侵袭性的预测价值。结果两组患者年龄、性别、肿瘤直径、病灶位置比较差异均无统计学意义(P>0.05)。MSCT检查显示,两组患者肿瘤的生长方式比较差异无统计学意义(P>0.05);侵袭组患者病灶形态不规则、边界不清晰、包膜不完整或无包膜、肾包膜突破不完整、肿瘤内有粗大供血动脉的比例均高于非侵袭组,差异有统计学意义(P<0.05)。两组患者病灶实质期、延迟期的MSCT平扫值比较差异无统计学意义(P>0.05),而侵袭组病灶动脉期的MSCT平扫值高于非侵袭组,差异有统计学意义(P<0.05)。两组患者病灶实质期、延迟期强化程度比较差异无统计学意义(P>0.05),而侵袭组病灶动脉期的强化程度高于非侵袭组,差异有统计学意义(P<0.05)。ROC曲线分析显示,MSCT动脉期平扫值及强化程度预测CCRCC侵袭性的曲线下面积分别为0.694、0.776,敏感度分别为70.97%、80.65%,特异度分别为63.49%、66.67%。结论MSCT病灶形态、边界、包膜情况、肾包膜突破情况、肿瘤内有粗大供血动脉等特征可间接反映CCRCC的侵袭性,MSCT动脉期平扫值及强化程度对CCRCC侵袭性具有较高的预测价值。Objective To explore the evaluation value of multi-slice spiral CT(MSCT)in invasiveness of clear cell renal cell carcinoma(CCRCC).Method A total of 94 patients with CCRCC treated in the hospital were enrolled between February 2019 and February 2024.According to pathological results,they were divided into the invasion group(n=31)and non-invasion group(n=63).All patients underwent MSCT examination.The characteristics,plain scan value and enhancement degree of MSCT were compared between the two groups.The predictive value of MSCT for CCRCC invasiveness was analyzed by receiver operating characteristic(ROC)curves.Result MSCT examination showed that there was no significant difference in growth pattern between the two groups(P>0.05),but there were significant differences in lesion morphology,boundary,envelope,breakthrough of renal envelope and extensive feeding artery in tumors(P<0.05).There was no significant difference in MSCT plain scan values during parenchyma stage and delayed stage between the two groups(P>0.05),but MSCT plain scan value during arterial stage in invasion group was greater than that in non-invasion group(P<0.05).There was no significant difference in enhancement degree during parenchyma stage and delayed stage between the two groups(P>0.05),but enhancement degree during arterial stage in invasion group was greater than that in non-invasion group(P<0.05).ROC curves analysis showed that AUC,sensitivity and specificity of MSCT arterial phase and enhancement degree during arterial phase for predicting CCRCC invasiveness were 0.694,0.776,70.97%,80.65%,63.49%and 66.67%respectively(P<0.05).Conclusion MSCT characteristics(lesion morphology,boundary,envelope,breakthrough of renal envelope,extensive feeding artery in tumors)can indirectly indicate the invasiveness of CCRCC.MSCT arterial phase and enhancement degree during arterial phase have high predictive value for the invasiveness.

关 键 词：多层螺旋CT 肾透明细胞癌 侵袭性 评估价值 

分 类 号：R445[医药卫生—影像医学与核医学]