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| Value of Multi-slice Spiral CT in the Differential Diagnosis of Renal Clear Cell Carcinoma and Lipoid Renal Angiomyolipoma |
| YANG Lei, FAN Xiao-ling |
| Department of Medical Imaging,Baoji People's Hospital,Baoji Shaanxi 721000 |
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Abstract 【Objective】 To explore the value of multi-slice spiral CT (MSCT) in the differential diagnosis of renal clear cell carcinoma (ccRCC) and lipoid renal angiomyolipoma (AMLmf) and to analyze the value of MSCT in evaluating the Fuhrman classification of ccRCC patients. 【Methods】 A total of 28 patients with ccRCC were divided into group A and 27 patients with AMLmf were divided into group B. The imaging signs (tumor size,tumor calcification,cystic change,hemorrhage,visible blood vessels and multiple lesions),CT values (plain scan,cortical phase,medullary phase and excretory phase) and tumor enhancement patterns (homogeneous enhancement,heterogeneous enhancement,main peripheral and septal enhancement) of MSCT were compared between the two groups. The CT value (plain scan,cortical phase and medullary phase) and pseudocapsule of patients with different Fuhrman grades in the group A were compared. 【Results】 The diameter of tumor in the group A was significantly larger than that in the group B (P<0.05); The proportion of patients with cystic change,multiple lesions and tumor hemorrhage in the group A was significantly higher than that in the group B (P<0.05); There was no significant difference between the two groups in the proportion of patients with tumor calcification and visible blood vessels (P>0.05). The CT value of plain scan in the group A was significantly lower than that in the group B (P<0.05); The CT value of cortical phase in the group A was significantly higher than that in the group B (P<0.05); There was no significant difference in CT values between the two groups in medullary phase and excretory phase (P>0.05); The proportion of patients with heterogeneous tumor enhancement in the group A was significantly higher than that in the group B (P<0.05). The CT values of cortex and medulla in patients with Fuhrman grade Ⅰ~Ⅱ were significantly higher than those in patients with grade Ⅲ~Ⅳ (P<0.05); There was no significant difference between the two CT values (P>0.05); The rate of pseudocapsule integrity in patients with grade Ⅰ to Ⅱ was significantly higher than that in patients with grade Ⅲ to Ⅳ (P<0.05). 【Conclusion】 There are differences in MSCT imaging characteristics,CT value of plain scan and tumor enhancement mode between ccRCC and AMLmf. At the same time,the CT value of cortical and medullary phase and pseudocapsule can evaluate the Fuhrman grading of ccRCC patients.
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Received: 16 June 2022
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[1] 范敏,徐仁芳,陆皓,等. 术前C反应蛋白/白蛋白比值在预测肾透明细胞癌患者预后方面的价值[J].中华泌尿外科杂志,2017,38(12):918-922.
[2] 李猛,陈亚明. 肾透明细胞癌CT强化特征与病理分级的相关性分析[J].安徽医学,2018,39(8):990-992.
[3] 沈培永. CT定量分析对肾脏乏脂血管平滑肌脂肪瘤与肾透明细胞癌的鉴别诊断[J].放射学实践,2018,33(7):717-721.
[4] 孔铭新,于曰俊,马飞飞,等. 锥形束CT双期扫描在肝恶性肿瘤介入治疗中的应用[J].介入放射学杂志,2019,28(1):38-41.
[5] DELAHUNT B,SIKA-PAOTONU D,BETHWAITE P B,et al. Fuhrman grading is not appropriate for chromophobe renal cell carcinoma[J].Am J Sur Path,2007,31(6):957-960.
[6] 丁玉芹,于泳,罗荣奎,等. 多元Logistic回归分析CT征象鉴别乏脂肪血管平滑肌脂肪瘤和肾透明细胞癌的价值[J].临床放射学杂志,2019,38(3):495-499.
[7] 朱晓红,刘斌,余永强. 乏脂肪肾脏血管平滑肌脂肪瘤与透明细胞癌的MSCT鉴别诊断[J].安徽医学,2017,38(6):766-768.
[8] 刘凯,曾自三. 肾乏脂肪血管平滑肌脂肪瘤与肾癌亚型的CT鉴别诊断[J].中国CT和MRI杂志,2015,13(11):78-82.
[9] 王禹,董潇,孔垂泽,等. 不同病理类型肾肿瘤的影像学特点和病理学特点分析[J].中华泌尿外科杂志,2019,40(5):374-379.
[10] WAN F N,ZHU Y,HAN C T,et al.Identification and validation of an 8-gene expression signature for predicting high Fuhrman grade renal cell carcinoma[J].Int J Cancer,2017,140(5):1199-1208.
[11] 杨保智,侯浩宇,杨浩,等. 肾透明细胞癌增强CT表现与病理Fuhrman核分级的关系[J].医学影像学杂志,2018,28(1):109-112.
[12] 李淑兰,侯春霞,周祖邦,等. 分组方法对超声造影诊断肾透明细胞癌假包膜显示率的影响[J].中国临床医学影像杂志,2015,26(5):334-336.
[13] IMAO T,EGAWA M,TAKASHIMA H,et al. Inverse correlation of microvessel density with metastasis and prognosis in renal cell carcinoma[J].Int J Urol,2004,11(11):948-953.
[14] 周宏伟,蒋元文,张祖林,等. 透明细胞肾细胞癌多层CT影像表现特点分析[J].中国CT和MRI杂志,2014,12(7):66-67. |
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2023, Vol. 40 
