多层螺旋CT动态增强扫描在肾透明细胞癌和肾嫌色细胞癌及肾乳头状癌鉴别诊断的应用价值  

Application value of dynamic enhanced multi-slice spiral CT in differential diagnosis of clear cell carcinoma of kidney,chromophobe cell carcinoma of kidney and papillary carcinoma of kidney

作　　者：李信[1] 李卫平[1] 侯海文[1] LI Xin;LI Weiping;HOU Haiwen(Imaging Medical Center,Chenzhou First People's Hospital,Chenzhou,Hu'nan,423000,China)

机构地区：[1]郴州市第一人民医院影像医学中心,湖南郴州423000

出　　处：《当代医学》2024年第36期161-164,共4页Contemporary Medicine

摘　　要：目的分析多层螺旋CT(multi-slice spiral CT,MSCT)动态增强扫描在肾透明细胞癌(clear cell carcinoma of kidney,CCRCC)、肾嫌色细胞癌(chromophobe cell carcinoma of kidney,ChRCC)及肾乳头状癌(papillary carcinoma of kidney,PRCC)鉴别诊断的应用价值。方法选取2019年1月至2021年1月郴州市第一人民医院收治的80例肾癌患者作为研究对象,根据肾癌类型的不同分为CCRCC组(n=42)、PRCC组(n=23)与ChRCC组(n=15)。所有患者均行MSCT平扫加动态增强扫描,比较3组平扫及增强CT影像学表现、平扫及3期校正强化CT值。结果3组钙化、囊变、坏死发生率及强化均匀占比比较差异无统计学意义,3组出血、皮髓质期发生填充性强化、血管样强化发生率比较差异有统计学意义(P<0.05);ChRCC组出血发生率高于CCRCC组、PRCC组,髓质期填充性强化发生率低于CCRCC组、PRCC组,血管样强化发生率低于PRCC组,差异有统计学意义(P<0.017)。3组平扫CT值比较差异无统计学意义;3组皮髓期、实质质期和排泄期校正强化CT值比较差异有统计学意义(P<0.05),CCRCC组皮髓期、实质质期和排泄期校正强化CT值均高于ChRCC组、PRCC组,且PRCC组高于ChRCC组,差异有统计学意义(P<0.05)。结论借助MSCT动态增强扫描鉴别诊断CCRCC、ChRCC、PRCC,临床价值较高,可结合其他检查方法,获得更好的诊断效果,提高肾癌亚型病变的诊断符合率。Objective To analyze the application value of dynamic enhanced multi-slice spiral CT(MSCT)in differential diagnosis of clear cell carcinoma of kidney(CCRCC),chromophobe cell carcinoma of kidney(ChRCC)and papillary carcinoma of kidney(PRCC).Methods A total of 80 patients with renal cancer admitted to the Chenzhou First People's Hospital from January 2019 to January 2021 were selected as the study subjects,and they were divided into the CCRCC group(n=42),PRCC group(n=23)and the ChRCC group(n=15)according to different types of renal cancer.All patients were treated with MSCT plain scan plus dynamic enhanced scan,the imaging findings of plain scan and enhanced CT,the values of plain scan and three-stage corrected enhanced CT were compared among the three groups.Results There were no significant differences in the incidence of calcification,cystic degeneration,necrosis and uniform proportion of reinforcement among the three groups,while there were significant differences in the incidence of hemorrhage,filling reinforcement and vasoid reinforcement in the cutaneous medullary stage among the three groups(P<0.05).The incidence of hemorrhage in the ChRCC group was higher than that in the CCRCC group and the PRCC group,the incidence of filler enhancement in the medullary stage was lower than that in the CCRCC group and the PRCC group,and the incidence of angioid enhancement was lower than that in the PRCC group,and the differences were statistically significant(P<0.017).There was no significant difference in the CT values among the three groups;there were significant differences in the corrected enhanced CT values of the skin and pulp stage,parenchyma stage and excretion stage among the three groups(P<0.05);the corrected enhanced CT values in the CCRCC group of the pulp stage,parenchymal phase and excretory phase were higher than those in the ChRCC group and the PRCC group,and the PRCC group was higher than the ChRCC group,and the differences were statistically significant(P<0.05).Conclusion The differential diagnosis of C

关 键 词：肾透明细胞癌 肾嫌色细胞癌 肾乳头状癌 多层螺旋CT 动态增强扫描 

分 类 号：R73[医药卫生—肿瘤]