肾透明细胞癌强化程度的CT评估价值

Evaluating value of spiral CT in enhanced-degree of renal clear cell carcinoma

目的探讨16排螺旋CT双期增强扫描对不同大小肾透明细胞癌强化程度的价值。方法回顾性分析21例经手术病理证实的肾透明细胞癌的CT强化程度,根据肿瘤直径大小把肾癌分成直径<4cm和>4cm两组,分别测量各组肿瘤皮髓期的CT值和同层面肌肉组织的CT值,同时计算肿瘤的相对CT值,通过统计学分析两组肿瘤CT值的相关性。结果直径<4cm组肿瘤的平均大小为(2.59±0.66)cm,平均CT值为(105.66±18.43)HU,平均相对CT值为(1.78±0.24);直径>4cm组肿瘤的平均大小为(5.66±1.22)cm,平均CT值为(112.04±24.71)HU,平均相对CT值为(1.95±0.50)。两组肾透明细胞癌的CT值及相对CT值间差异无统计学意义(z、t分别=-0.14、-1.06,P均>0.05)。结论双期增强CT能够准确反映肾透明细胞癌的血供特点。肾透明细胞癌的强化程度不能作为评估肿瘤生物学行为的独立因素。

Objective To evaluate the value of biphasic dynamic enhanced 16-slice computed tomography （CT） in analyzing the enhanced degree of different diameter renal clear cell carcinoma. Methods The enhancement degree of 21 cases pathology-proven renal clear cell carcinoma during biphasic contrast enhanced spiral CT scans were reviewed. The renal clear cell carcinoma patients were divided into two groups with diameter 〈4cm （group A） and 〉 4cm （group B） according to initial diameter of renal cell carcinoma. Before surgery, plain CT scan and biphasic （cortico-medullary phase, paranchymal phase） dynamic contrast enhanced scan were undertaken. The attenuation of each tumor and muscle in cortico-medullary phase after enhancement was calculated via measuring region of interesting （ROI）, and tumor-to-muscle ratio （RTM）. Then the relativities of CT values and RTM of two groups were analysed by using statistical methods. Results The average diameter, CT value and RTM of both group A and group B were （2.59 ±0.66）cm, （105.66±18.43）HU, （1.78±0.24） and （5.66±1.22）cm, （ 112.04 ±24.71 ）HU, （ 1.95 ±0.50）. There were no significant differences between the CT value or RTM of group A and group B （z,t=-0.14, -1.06, P〉 0.05）. Conclusions The biphasic contrast enhanced spiral CT scan can accurately indicate microvessel density characteristic of renal clear cell carcinoma. The enhanced degree of renal clear cell carcinoma should not be absolute factor in evaluating the biological behavior and malignance of the tumor.