后肾腺瘤与乳头状肾细胞癌的CT鉴别诊断  

CT differential diagnosis between metanephric adenoma and papillary renal cell carcinoma

作　　者：潘冬梅 王敏[1] 李正腾 王作祥[1] 于永梅[1] 戴辰晨 PAN Dongmei;WANG Min;LI Zhengteng;WANG Zuoxiang;YU Yongmei;DAI Chenchen(Department of Radiology,Jining No.1 People's Hospital,Jining 272000,China;Department of Radiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]山东省济宁市第一人民医院放射科,山东济宁272000 [2]复旦大学附属中山医院放射科,上海200032

出　　处：《医学影像学杂志》2025年第3期69-73,共5页Journal of Medical Imaging

基　　金：山东省济宁市重点研发计划项目(编号:2023YXNS074)。

摘　　要：目的 对比分析后肾腺瘤(MA)与乳头状肾细胞癌(PRCC)的CT表现特征,提高对两者的鉴别诊断水平。方法 选取经术后病理证实的10例MA及26例PRCC患者的术前临床及CT资料。采用Fisher确切概率法对两组的临床特征(性别、临床症状、侧别)及CT表现(病灶位置、与肾窦的关系、生长模式、边界、形状、成分、平扫密度、钙化、出血)进行比较;采用独立样本t检验对两组的年龄、病灶长短径、平扫及增强两期病灶CT值、增强两期肿瘤的相对增强率进行比较。结果 PRCC组男性多发,MA组女性多发,两者差异有统计学意义(P<0.05)。两组病灶与肾窦的关系、两组肿瘤的皮质期相对增强率差异有统计学意义(P<0.05)。性别、与肾窦关系、皮质期相对增强率对于鉴别MA和PRCC受试者工作特征(ROC)曲线下面积分别为0.815(95%CI:0.663~0.968)、0.738(95%CI:0.579~0.898)、0.754(95%CI:0.599~0.908)。结论 MA与PRCC的临床特征和增强CT表现(性别、与肾窦关系、皮质期相对增强率)有一定差异,有助于临床术前鉴别诊断。Objective Comparative analysis of CT features between metanephric adenoma(MA)and papillary renal cell car-cinoma(PRCC)was conducted so as to improve the level of differential diagnosis between the two.Methods The preoperative clinical and CT data of 10 MA and 26 PRCC patients confirmed by postoperative pathology were selected in this work.Fisher's exact probability method was used to compare the clinical features,like gender,clinical symptoms,and side,and CT manifesta-tions,includinglesion location,relationship with renal sinus,growth pattern,boundary,shape,composition,plain scan den-sity,calcification,and bleeding,between the two groups.Independent sample t-test was used to compare the age,length and di-ameter of lesions,CT values of plain and enhanced lesions,and relative enhancement rates of tumors in two groups.Results PRCC was more common in males and MA was more common in females,and the difference between the two was statistically sig-nificant.There were statistically significant differences in the relationship between lesions and renal sinuses and the relative en-hancement rates in cortical phase between the two groups(P<0.05).The working characteristic(ROC)areas under the ROC curves for distinguishing renal adenoma and papillary renal cell carcinoma were 0.815(95%CI:0.663~0.968),0.738(95%CI:0.579~0.898),and 0.754(95%CI:0.599~0.908).Conclusion The pathological and imaging manifestations of MA and PRCC have certain similarities,but enhanced CT scanning has certain clinical value for preoperative differentiation between the two.

关 键 词：后肾腺瘤 乳头状肾细胞癌 体层摄影术 X线计算机 

分 类 号：R737.11[医药卫生—肿瘤] R814.42[医药卫生—临床医学]