多房囊性肾癌与肾癌囊性变CT值和BOSNIAK分级比较

MULTILOCULAR CYSTIC RENAL CELL CARCINOMA AND CYSTIC DEGENERATION OF RENAL CELL CARCINOMA:A COMPARISON OF CT VALUE AND BOSNIAK CLASSIFICATION

目的比较多房囊性肾细胞癌(MCRCC)与肾细胞癌囊性变(CDRCC)的增强CT值和BOSNIAK分级差异,提高两种病变术前鉴别诊断的准确性。方法 2008—2013年,我院经手术病理证实的肾囊性恶性病变病人28例,其中MCRCC 11例,CDRCC 17例,比较两种病变在增强各期的CT值及BOSNIAK分级差异性。结果MCRCC皮质期、实质期CT值与CDRCC比较,差异有显著性(t=3.77、2.679,P<0.05);排泄期CT值与CDRCC比较,差异无显著性(P>0.05)。MCRCC中BOSNIAKⅢ级9例(82%),ⅡF级2例(18%),CDRCC中BOSNIAKⅢ级1例(6%),Ⅳ级16例(94%)。结论 BOSNIAK分级及三期增强CT值有助于术前更准确地鉴别MCRCC和CDRCC。

Objective To compare the difference in CT value and BOSNIAK classicification between multicular cystic renal cell carcinoma（MCRCC）and cystic degeneration of renal cell carcinoma（CDRCC）as well as improve the accuracy of preoperative differential diagnosis of these two kinds of lesions. Methods Between 2008—2013,28 cases of cystic malignant lesion of kidney（CMLK）were comfirmed in our hospital by operative pathology,of which,MCRCC were diagnosed in 11 cases,and CDRCC in 17.Difference of CT value and BOSNIAK grade in each enhancement period of the two lesions was analyzed. Results The difference in CT value of cortical phase and parenchymal phase between MCRCC and CDRCC was significant（t=3.77,2.679;P〈0.05）,and the difference of that of excretion phase was not significant（P〉0.05）.In MCRCC,BOSNIAK Ⅲ was found in nine cases（82%）,ⅡF in two（18%）,and in CDRCC,BOSNIAK Ⅲ was found in one case（6%）and Ⅳin 16（94%）. Conclusion BOSNIAK classification and three phase enhanced CT value are helpful to distinguish multicular cystic renal cell carcinoma and cystic degeneration of renal cell carcinoma more accurately before operation.