肾嫌色细胞癌螺旋CT多期动态增强特点分析

Analysis of Multiphase Dynamic Enhanced Spiral CT Features of Chromophobe Cell Renal Carcinoma

目的分析肾嫌色细胞癌螺旋CT多期动态增强特点。方法回顾性分析经手术病理证实的22例肾嫌色细胞癌术前螺旋CT影像资料,测量平扫及动态增强各期CT值,并观察肿瘤强化程度、强化模式及肿瘤形态学特征。结果 22例均为单侧发病,8例肿瘤密度均匀,4例伴有钙化,4例出现囊变,2例出现中央星形瘢痕,4例病灶内出现小片状坏死。CT平扫肿块呈等密度或稍低密度,15例为轻到中度强化,5例见重度强化,强化程度均低于肾皮质,2例未见明显强化,9例均匀强化,11例欠均匀强化。多期动态增强扫描皮髓质期、实质期和排泄期CT值分别为(80.3±24.7)HU、(69.5±10.4)HU、(57.6±16.7)HU。结论肾嫌色细胞癌CT平扫多表现为密度均匀的圆形等密度或稍低密度肿块,部分肿块伴有钙化、囊变及小片状坏死,典型中央星形瘢痕较为少见。尽管其有均匀强化倾向,但由于CT征象变化较大,与肾透明细胞癌及乳头状肾癌仍有重叠。

Objective To analyze the Multiphase Dynamic Enhanced Spiral CT Features of Chromophobe Cell Renal Carcinoma（ CRCC）. Methods The preoperative spiral CT image findings of 22 patients with pathologically proven CRCC,including CT values,degree of tumor enhancement,patterns of enhancement and morphological characteristics of the tumors were analyzed retrospectively. Results 22 cases were all unilateral,8 cases with uniform density,4 cases with calcification,4 cases with cystic change,2 cases with central stellate scar and 4 cases of lesions with multifocal patchy necrosis. All lesions showed isodensity or slightly lower density on CT scan,15 cases had slightly to moderate enhancement,5lesions had severe enhancement and 2 tumors were not enhanced. Compared to renal cortex,all cases had a lower degree of enhancement in all enhanced phases. 9 lesions had homogeneous enhancement,whereas 11 lesions had heterogeneous enhancement. Mean CT values were 80. 3 HU（ corticomedullary phase）,69. 5 HU（ nephrographic phase）,and 57. 6 HU（ excretory phase）. Conclusion Chromophobe renal cell carcinoma showed isodensity or slightly lower density on CT scan,some tumors showed calcification,cystic change or patchy necrosis,typical of the central stellate scar was relatively rare. CRCCs were found to have a wider variability of CT features,although they did have a greater propensity for homogeneity. Their enhancement characteristics fell in between those of clear cell and papillary RCC,although there was a considerable overlap.