中国医学影像学杂志
中國醫學影像學雜誌
중국의학영상학잡지
CHINESE JOURNAL OF MEDICAL IMAGING
2013年
10期
761-764
,共4页
癌,肾细胞%腺瘤,嗜酸粒细胞%体层摄影术,螺旋计算机%图像增强%诊断,鉴别
癌,腎細胞%腺瘤,嗜痠粒細胞%體層攝影術,螺鏇計算機%圖像增彊%診斷,鑒彆
암,신세포%선류,기산립세포%체층섭영술,라선계산궤%도상증강%진단,감별
Carcinoma,renal cell%Adenoma,oxyphilic%Tomography,spiral computed%Image enhancement%Diagnosis,differential
目的：探讨CT动态增强扫描鉴别肾嫌色细胞癌与肾嗜酸细胞瘤的价值。资料与方法回顾性分析经病理证实的24例肾嫌色细胞癌与17例肾嗜酸细胞瘤的影像学特点，比较两种病变增强扫描后皮髓质期、实质期CT值变化的百分比（简称病灶强化百分比），以及肿瘤病灶相对于肾皮质的强化指数。结果肾嫌色细胞癌CT动态增强扫描后皮髓质期、实质期病灶强化百分比分别为（132.8±39.8）%、（99.2±32.5）%，肿瘤-肾皮质强化指数分别为0.31±0.11、0.30±0.12；肾嗜酸细胞瘤皮髓质期、实质期病灶强化百分比分别为（234.1±129.1）%、（195.4±87.1）%，肿瘤-肾皮质强化指数分别为0.66±0.33、0.68±0.28。两种肿瘤病灶强化百分比及肿瘤-肾皮质强化指数之间差异均有统计学意义（P<0.05）。实质期肿瘤-肾皮质强化指数阈值为0.44时，鉴别两种肿瘤的敏感度为82.4%，特异度为91.7%，Youden指数为0.74。结论 CT动态增强扫描，特别是实质期肿瘤-肾皮质强化指数有助于肾嫌色细胞癌与嗜酸细胞瘤的鉴别诊断。
目的：探討CT動態增彊掃描鑒彆腎嫌色細胞癌與腎嗜痠細胞瘤的價值。資料與方法迴顧性分析經病理證實的24例腎嫌色細胞癌與17例腎嗜痠細胞瘤的影像學特點，比較兩種病變增彊掃描後皮髓質期、實質期CT值變化的百分比（簡稱病竈彊化百分比），以及腫瘤病竈相對于腎皮質的彊化指數。結果腎嫌色細胞癌CT動態增彊掃描後皮髓質期、實質期病竈彊化百分比分彆為（132.8±39.8）%、（99.2±32.5）%，腫瘤-腎皮質彊化指數分彆為0.31±0.11、0.30±0.12；腎嗜痠細胞瘤皮髓質期、實質期病竈彊化百分比分彆為（234.1±129.1）%、（195.4±87.1）%，腫瘤-腎皮質彊化指數分彆為0.66±0.33、0.68±0.28。兩種腫瘤病竈彊化百分比及腫瘤-腎皮質彊化指數之間差異均有統計學意義（P<0.05）。實質期腫瘤-腎皮質彊化指數閾值為0.44時，鑒彆兩種腫瘤的敏感度為82.4%，特異度為91.7%，Youden指數為0.74。結論 CT動態增彊掃描，特彆是實質期腫瘤-腎皮質彊化指數有助于腎嫌色細胞癌與嗜痠細胞瘤的鑒彆診斷。
목적：탐토CT동태증강소묘감별신혐색세포암여신기산세포류적개치。자료여방법회고성분석경병리증실적24례신혐색세포암여17례신기산세포류적영상학특점，비교량충병변증강소묘후피수질기、실질기CT치변화적백분비（간칭병조강화백분비），이급종류병조상대우신피질적강화지수。결과신혐색세포암CT동태증강소묘후피수질기、실질기병조강화백분비분별위（132.8±39.8）%、（99.2±32.5）%，종류-신피질강화지수분별위0.31±0.11、0.30±0.12；신기산세포류피수질기、실질기병조강화백분비분별위（234.1±129.1）%、（195.4±87.1）%，종류-신피질강화지수분별위0.66±0.33、0.68±0.28。량충종류병조강화백분비급종류-신피질강화지수지간차이균유통계학의의（P<0.05）。실질기종류-신피질강화지수역치위0.44시，감별량충종류적민감도위82.4%，특이도위91.7%，Youden지수위0.74。결론 CT동태증강소묘，특별시실질기종류-신피질강화지수유조우신혐색세포암여기산세포류적감별진단。
Purpose To explore the diagnostic value of dynamic contrast-enhanced CT (DCE-CT) in the differential diagnosis of chromophobic renal cell carcinoma (CRCC) and renal oncocytoma (RO). Materials and Methods A retrospective study was carried out on the DCE-CT findings of 24 patients with pathologically-proved CRCCs and 17 patients with pathologically-confirmed ROs. The enhancement percentage (EP) and the enhancement index (EI) of both types of lesions were compared on corticomedullary phase and nephrographic phase. Results CRCCs on corticomedullary phase and nephrographic phase:EP (132.8±39.8)%and (99.2±32.5)%, respectively;EI 0.31±0.11 and 0.30±0.12, respectively. ROs on corticomedullary phase and nephrographic phase:EP (234.1±129.1)%and (195.4±87.1)%, respectively;EI 0.66±0.33 and 0.68±0.28, respectively. Both EP and EI of CRCCs and ROs showed statistical difference (P<0.05). As the threshold value of EI on nephrograhic phase was 0.44, the sensitivity was 82.4%, specificity was 91.7% and Youden index was 0.74. Conclusion Imaging features of DCE-CT, especially EI on nephrographic phase, are helpful in the differential diagnosis of CRCC and RO.
