乳头状肾癌亚型的CT鉴别诊断价值

Value of CT in Differential Diagnosis of Subtypes of Papillary Renal Cell Carcinoma

目的探讨乳头状肾癌(PRCC)亚型的CT鉴别诊断价值。方法回顾分析21例经病理证实PRCC患者(Ⅰ型9例、Ⅱ型12例)的影像资料,比较两者之间肿瘤的大小、形态、边界、平扫CT值及动态增强三期CT值、强化均匀程度、肿瘤的扩散情况,分析两者之间影像学的差异。结果 PRCCⅠ型与Ⅱ型肿瘤形态(P=0.024)、边界(P=0.005)、强化均匀程度(P=0.032)及肿瘤的扩散情况(P=0.007)有统计学差异,Ⅰ型肿瘤一般呈类圆形无分叶、边界清、强化均匀、无肿瘤扩散,而Ⅱ型肿瘤多呈不规则形有分叶、边界不清、强化不均匀、有肿瘤扩散。两者大小、平扫CT值及动态增强三期CT值无统计学差异(P>0.05)。结论 PRCCⅠ型与Ⅱ型在肿瘤形态、边界、强化均匀程度及肿瘤扩散情况方面有明显差异,CT对两者的鉴别诊断有较大价值。

Objective To evaluate the differential diagnostic value of CT in subtypes of papillary renal cell carcinoma. Methods The imaging findings of 21 patients with pathologically proved papillary renal ceil carcinoma （type I 9 eases, typeⅡ 12 cases）were retrospectively analyzed. The tumor size, shape, margin, enhancement degree and pattern （homoge- neous, heterogeneous） ,tumor invasion were compared between two types. Results The shape, margin, enhancement pat- tern and tumor invasion had significantly differences between two types. The tumors of Type I always showed round with distinct margins ,homogeneous density ,no tumor invasion. Whereas the tumors of type Ⅱ always showed irregular with in- distinct margins, heterogeneous density and tumor invasion. The tumor size and enhancement degree showed no statistical difference（ P 〉 0. 05 ） between two types. Conclusion Some CT features , including tumor shape, margin, enhancement pattern, tumor invasion, are helpful in differential diagnosis of subtypes of papillary renal cell carcinoma.