放射学实践
放射學實踐
방사학실천
RADIOLOGIC PRACTICE
2014年
8期
949-952
,共4页
肾肿瘤%血管平滑肌脂肪瘤%透明细胞癌%体层摄影术,X 线计算机
腎腫瘤%血管平滑肌脂肪瘤%透明細胞癌%體層攝影術,X 線計算機
신종류%혈관평활기지방류%투명세포암%체층섭영술,X 선계산궤
Renal tumor%Angiomyolipoma%Clear cell carcinoma%Tomography,X-ray computed
目的：提高对长径≤4 cm 的乏脂肪型血管平滑肌脂肪瘤（AML）和肾透明细胞癌的 CT 诊断准确性。方法：对长径≤4 cm 的14例（16个病灶）乏脂肪型 AML 和16例（16个病灶）肾透明细胞癌的 CT 形态学表现（楔形征、肿瘤位置、钙化、假包膜及瘤内血管）及平扫、增强 CT 值进行测量及分析，所有肿瘤均经手术病理证实。结果：两组中楔形征（P ＝0．023）、瘤内血管（P ＝0．029）、假包膜（P ＝0．023）、平扫 CT 值（P ＜0．001）、皮髓质期及排泄期的绝对强化值（分别P ＝0．009和0．044）及相对强化幅度（分别 P ＝0．008和0．020）的差异有统计学意义，其中两期的相对强化幅度的 Pear-son 相关系数（r＝0．461和-0．409）较绝对强化值（r＝0．456和-0．366）高。而钙化（P ＝0．484）及肿瘤位置（P ＝0．473）在两组间的差异无统计学意义（P ＞0．05）。排泄期 CT 相对强化幅度＞-19．2％时，诊断乏脂肪型 AML 的特异度及敏感度分别为87．5％和25．0％。结论：乏脂肪型 AML 中楔形征多见，瘤内血管、假包膜少见；其平扫 CT 值较透明细胞癌病灶高，与竖脊肌相似，皮髓质期相对强化幅度较透明细胞癌低，排泄期对比剂退出较少，其中肿瘤的 CT 相对强化幅度对诊断更有意义。
目的：提高對長徑≤4 cm 的乏脂肪型血管平滑肌脂肪瘤（AML）和腎透明細胞癌的 CT 診斷準確性。方法：對長徑≤4 cm 的14例（16箇病竈）乏脂肪型 AML 和16例（16箇病竈）腎透明細胞癌的 CT 形態學錶現（楔形徵、腫瘤位置、鈣化、假包膜及瘤內血管）及平掃、增彊 CT 值進行測量及分析，所有腫瘤均經手術病理證實。結果：兩組中楔形徵（P ＝0．023）、瘤內血管（P ＝0．029）、假包膜（P ＝0．023）、平掃 CT 值（P ＜0．001）、皮髓質期及排洩期的絕對彊化值（分彆P ＝0．009和0．044）及相對彊化幅度（分彆 P ＝0．008和0．020）的差異有統計學意義，其中兩期的相對彊化幅度的 Pear-son 相關繫數（r＝0．461和-0．409）較絕對彊化值（r＝0．456和-0．366）高。而鈣化（P ＝0．484）及腫瘤位置（P ＝0．473）在兩組間的差異無統計學意義（P ＞0．05）。排洩期 CT 相對彊化幅度＞-19．2％時，診斷乏脂肪型 AML 的特異度及敏感度分彆為87．5％和25．0％。結論：乏脂肪型 AML 中楔形徵多見，瘤內血管、假包膜少見；其平掃 CT 值較透明細胞癌病竈高，與豎脊肌相似，皮髓質期相對彊化幅度較透明細胞癌低，排洩期對比劑退齣較少，其中腫瘤的 CT 相對彊化幅度對診斷更有意義。
목적：제고대장경≤4 cm 적핍지방형혈관평활기지방류（AML）화신투명세포암적 CT 진단준학성。방법：대장경≤4 cm 적14례（16개병조）핍지방형 AML 화16례（16개병조）신투명세포암적 CT 형태학표현（설형정、종류위치、개화、가포막급류내혈관）급평소、증강 CT 치진행측량급분석，소유종류균경수술병리증실。결과：량조중설형정（P ＝0．023）、류내혈관（P ＝0．029）、가포막（P ＝0．023）、평소 CT 치（P ＜0．001）、피수질기급배설기적절대강화치（분별P ＝0．009화0．044）급상대강화폭도（분별 P ＝0．008화0．020）적차이유통계학의의，기중량기적상대강화폭도적 Pear-son 상관계수（r＝0．461화-0．409）교절대강화치（r＝0．456화-0．366）고。이개화（P ＝0．484）급종류위치（P ＝0．473）재량조간적차이무통계학의의（P ＞0．05）。배설기 CT 상대강화폭도＞-19．2％시，진단핍지방형 AML 적특이도급민감도분별위87．5％화25．0％。결론：핍지방형 AML 중설형정다견，류내혈관、가포막소견；기평소 CT 치교투명세포암병조고，여수척기상사，피수질기상대강화폭도교투명세포암저，배설기대비제퇴출교소，기중종류적 CT 상대강화폭도대진단경유의의。
Objective:To study the differentiation between angiomyolipomas (AMLs)with minimal fat and clear cell renal cell carcinomas whose size all smaller than 4cm,according to their morphologic and CT enhancement features.Methods:The morphologic manifestations (wedge sign,location,calcification,pseudo capsule,and intra-tumoral vessels),unenhanced CT value and enhanced CT value in 14 cases (16 lesions)of AMLs with minimal fat and 16 cases (16 lesions)of clear cell renal cell carcinomas with diameter ≤4cm,were statistically analyzed.All the lesions were confirmed pathologically.Results:For the AMLs group and clear cell renal cell carcinoma group,there was significant difference in wedge sign (P =0.023),intra-tumoral vessel (P =0.029),pseudocapsule (P =0.023),unenhanced CT value (P <0.001)and the absolute/relative atte-nuation values of the two phase (cortico-medullary phase and exctretory phase)with P =0.009,0.04,0.008 and 0.020 re-spectively,meanwhile the Pearson correlation coefficient of the relative enhancement values (r=0.456 and -0.366 respec-tively)of the two phase were higher than that of the absolute enhancement values (P =0.456 and -0.366 respectively). While the difference of the calcification (P =0.484)and location of the tumor (P =0.473)had no statistical significance be-tween the two groups.The specificity and sensitivity were respectively 87.5% and 25% for diagnosing AML with minimal fat when the relative enhancement degree in the excretory phase >-19.2%.Conclusion:Angiomyolipomas with minimal fat often showed wedge sign,though the intra-tumoral vessels and pseudocapsule rarely appeared.The unenhanced CT value was higher than that in clear cell renal cell carcinoma,similar to that of the erector spinae.Its enhancement level was lower than that of clear cell renal cell carcinoma in the corticomedullary phase,contrast washout was less than that in the clear re-nal cell carcinoma in the excretory phase.The relative enhancement degree was more helpful for the diagnosis.
