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| MSCT对乏脂肾血管平滑肌脂肪瘤与非透明细胞肾癌的鉴别诊断 |
| Differential diagnosis of MSCT between lipid-poor renal angiomyolipoma and non-clean cell renal carcinoma |
| 投稿时间：2023-06-06 修订日期：2023-11-24 |
| DOI： |
| 中文关键词: 肾肿瘤；癌；肾细胞；血管平滑肌脂肪瘤；X 线计算机；体层摄影术 |
| 英文关键词: neoplasms; Carcinoma; Angiomyolipoma; renal cell; Tomography;X-ray computed; Diagnosis;differential |
| 基金项目:CT影像组学联合传统影像学在良恶性小肾肿瘤诊断中的应用研究, |
| 作者 | 单位 | 邮编 | | 于永梅* | 济宁市第一人民医院 | 272000 | | 王艳芹 | 济宁市中医院 | | | 韩翔宇 | 济宁市第一人民医院 | | | 王敏 | 济宁市第一人民医院 | | | 陈明井 | 济宁市第一人民医院 | | | 潘冬梅 | 济宁市第一人民医院 | |
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| 中文摘要: |
| [摘要] 目的 分析乏脂肾血管平滑肌脂肪瘤（AML）与非透明细胞肾癌（肾乳头状细胞癌、嫌色细胞癌）的CT特征，提高病变的鉴别诊断效能。方法 回顾性分析经手术病理证实乏脂 AML19例、肾乳头状细胞癌（PRCC）16例及肾嫌色细胞癌（ChRCC）22 例。测量肿瘤四期（平扫期、皮髓质期、实质期及排泄期）相同ROI的CT值及健侧肾皮质CT值，计算肿瘤强化百分比、多期相净增值、相对强化比并进行统计学分析。结果 乏脂AML在平扫期及皮髓质期CT值高于PRCC与ChRCC的CT值，差异均有统计学意义（均P<0.05），在实质期及排泄期，乏脂AML与两者比较差异无统计学意义（均P>0.05）。乏脂AML在皮髓质期、实质期和排泄期的强化百分比高于PRCC、ChRCC，差异均有统计学意义（均P<0.05）。乏脂AML与PRCC、CRCC在皮髓质期及实质期多期相净增值、相对强化比的差异均有统计学意义（均P<0.05），在排泄期差异无统计学意义（P>0.05）。结论 乏脂AML与非透明细胞Ca平扫及增强扫描有其特征性CT表现，强化百分比、多期相净增值、相对强化比可进一步提高AML与非透明细胞肾癌的诊断及鉴别诊断能力。 |
| 英文摘要: |
| 【Abstract】 Objective To analyze the CT features of lipid-poor renal angiomyolipoma (AML) and non clear cell renal carcinoma, and to improve the differential diagnosis of the disease.Methods This retrospective study involved 20 cases of lipid-poor AML, 17 cases of papillary renal cell carcinoma（PRCC）, and 19 cases of chromophobe renal cell carcinoma (ChRCC) . The diagnosis of all cases was confirmed by surgery and pathology. The CT values in region of interest (ROI) were measured in both ipsilateral and contralateral kidneys in the plain scan phase, cortical phase ,nephrogenic phase and excretory phase.the enhancement percentage, multiphase net increase and relative enhancement ratio were calculated and statistically analyzed.Results In the plain scan and cortical phase , the CT values of lipid-poor AML were higher than those of PRCC and ChRCC,and the differences were statistically significant (P<0.05).In the nephrogenic and excretory phases, there was no difference in CT values between the lipid-poor AML and non-ccRCC groups . In the cortical phase , nephrogenic and excretory phases, the enhancement percentage of lipid-poor AML was higher than that of PRCC and ChRCC,and the differences were statistically significant (P<0.05). Once comparing the lipid-poor AML and PRCC, the statistical differences of multiphase net increase and relative enhancement ratio were identified in both corticomedullar and the nephrogenic phases. In the comparison of lipid-poor AML and ChRCC, the multiphase net increase and relative enhancement ratio demonstrated the statistical differences in both corticomedullar and the nephrogenic phases（P<0.05）. However, in the excretion phase, none of the above measurements showed statistical difference (P>0.05).Conclusion Lipid-poor AML, PRCC and ChRCC have specific CT features in the plain scan and enhanced scan phases. Adopting the enhancement percentage ,multiphase net increase and relative enhancement ratio can further improve the differential diagnostic accuracy of AML from non-clean cell renal carcinoma. |
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