不典型肾实质内占位的高场强MRI与螺旋CT诊断价值分析

Evaluation of atypical renal masses with high magnetic field MRI in comparison with helical CT

目的 :评价高场强MRI与螺旋CT平扫与动态增强检查对不典型肾实质内占位的诊断价值。方法 :37例肾实质内实性占位病变 ,包括肾癌 2 1例 ,少脂肪血管平滑肌脂肪瘤 6例 ,复杂良性囊性病变 7例 ,肾嗜酸性细胞瘤 1例 ,肾蔓状血管瘤伴出血 1例 ,多房囊性肾瘤 1例 ,均经 1.5TMRI及螺旋CT平扫及多期动态增强检查 ,CT与MRI检查时间间隔 2天至 2月。所有病例均经手术病理证实。结果 :高场强MRI检查对肾实质内不典型占位的诊断准确度为 78.4 % ,高于螺旋CT检查的准确度 (6 4 .9% )。两者有显著差异性 ,P =0 .0 2 5。MRI与CT检查相结合诊断准确度为 89.2 % ,明显高于MRI及CT检查 (P =0 .0 0 3、0 .0 0 1)。结论

Objective: To evaluate the role of MR imaging with conventional spin echo (SE) and dynamic contrast-enhanced (DCE) in atypical renal masse s combining with helical CT.Methods: 37 cases with renal masses,including r enal carcinoma (n=21), complex cysts(n=7), fatless angiomyolipoma (n= 6),racemos e angioma (n=1),cystic nephroma (n=1) and oncocytomas (n=1) underwent by both conventional spin echo (SE) and dynamic contrast-enhanced (DCE) MR ima ging examinations. Meanwhile, they were also studied by helical CT plain and DCE techniques at intervals from two days to two month. All cases were proved b y surgery and pathology.Results:The accuracy of MRI in diagnosing atypical renal masses was 78 .4%,higher than that of helical CT (64.9%),P=0.025.And that of MRI examina tion combined with helical CT was evidently different from MRI or CT (P=0.00 3、0.001).Conclusion:MRI examin ation in combination with CT has higher accur acy than MRI or heliacal CT in diagnosing atypical renal masses.