CT灌注成像在肾癌与乏脂肪型肾错构瘤鉴别诊断中的应用价值分析

The Application Differential Diagnosis Values Analysis of CT Perfusion Imaging in Renal Cancer and Lack of Fat Type Renal Angiomyolipoma

目的探讨CT灌注成像在肾癌与乏脂肪型肾错构瘤鉴别诊断中的应用价值。方法 2013年7月到2015年2月选择在我院进行诊治的肾实质内病变病例78例,其中肾癌28例(肾癌组),乏脂肪型肾错构瘤(肾错构瘤组)50例,两组都进行常规CT扫描、CT灌注成像和免疫组化分析,同时进行相关性分析。结果常规CT扫描显示肾错构瘤组的杯口征与劈裂征阳性率分别为82.0%和72.0%,而肾癌组分别为21.4%和25.0%,肾错构瘤组明显高于肾癌组(P<0.05)。CT灌注成像参数检测显示肾错构瘤组的BF、BV、PS值均低于肾癌组,而MTT值明显高于肾癌组,差异有显著性意义(P<0.05)。免疫组化分析显示肾错构瘤组的MVD计数与VEGF OD值明显低于肾癌组(P<0.05)。直线相关分析结果表明肾癌、乏脂肪型肾错构瘤的PS、BV、BF值和肿瘤的VEGF OD值、MVD计数有着正相关的关系(P<0.05),MTT值与VEGF OD值呈明显负相关(P<0.05)。结论 CT灌注成像在肾癌与乏脂肪型肾错构瘤鉴别诊断中的应用能准确地反映肾实质内病变内微血管的生成及肿瘤的血流状态,且与免疫组化指标存在一定的相关性,从而在鉴别诊断方面具有一定临床应用价值。

Objective To investigate the application differential diagnosis values of CT perfusion imaging in renal cancer and lack of fat type renal angiomyolipoma. Methods From July 2013 to February 2015 in our hospital, 78 renal parenchyma disease for diagnosis and treatment were selected that included 28 patients of renal carcinoma （RC group） and 50 patients of the lack of fat type of renal angiomyolipoma （renal angiomyolipoma group）, two groups were given the routine CT scans, CT perfusion imaging and immunohistochemical analysis, and were given the correlation analysis. Results Conventional CT scan showed that the Levy and Splitting positive signs in the renal angiomyolipoma group were 82.0% and 72.0% respectively, while the RC group were 21.4% and 25.0% that the renal angiomyolipoma group were significantly higher than the RC group （P〈0.05）. The CT perfusion imaging parameters analysis showed that the BF, BV, PS values in the renal angiomyolipoma group were lower than the RC group, but the MTT values were higher than the RC group that compared between the difference were significantly（P〈0.05）. lmmunohistochenfistry showed that the MVD and VEGF OD value in the renal angiomyolipoma group were significantly lower than RC group （P〈0.05）. Linear correlation analysis showed the BF, BV, PS values in the renal cancer and lack of fat type renal angiomyolipoma were positively correlated to the MVD and VEGF OD values （P 〈0.05）, the MTT values were significantly negative correlated to the VEGF OD values （P 〈0.05）.Conclusion CT perfusion imaging in renal cancer and lack of fat type renal anootnyolipoma can accurately reflect lesion formation and tumor microvascular blood flow within the renal parenchyma, and are related to the immunohistochemical indexs, thus has some clinical values in the differential diagnosis.