≤3cm乳头状肾细胞癌与肾透明细胞癌的CT鉴别诊断

CT differential diagnosis of less than or equal to 3cm papillary renal cell carcinoma and clear cell renal cell carcinoma

目的分析直径≤3cm的乳头状肾细胞癌(PRCC)与直径≤3cm肾透明细胞癌(CCRCC)的CT表现,旨在提高二者的CT鉴别诊断水平。方法分析经手术病理证实的11例乳头状肾细胞癌(papillary renal cell carcinoma,PRCC)患者(直径≤3cm)及44例CCRCC患者(直径≤3cm)的CT扫描图像,包括CT征象、病灶密度值及增强程度值,对相应资料进行统计学分析。结果PRCC瘤内坏死或囊变少见(0/11),平扫边界清楚多见(11/11),增强后多表现为均匀强化(6/11);CCRCC瘤内坏死或囊变较PRCC多见(17/44),平扫边界不清较PRCC多见(20/44),增强后多表现为明显的不均匀强化(35/44)。PRCC两期增强密度值及病灶增强程度值均低于CCRCC。结论瘤内坏死或囊变、平扫边界、增强均匀性、病灶增强密度值及增强程度值有助于直径≤3cm PRCC与CCRCC的CT鉴别诊断。

Objective To study the differential diagnosis of less than or equal to 3cm papillary renal cell carcinoma and clear cell renal cell carcinoma by analyzing the CT findings. Methods CT scanning images of 11 PRCC patients （less than or equal to 3cm ） and d4 CCRCC（clear cell renal cell carcinoma） patients （less than or equal to 3cm ） were analyzed by CT signs, the density values and the enhanced degree values of the lesions. Results The necrosis or cystic degeneration was rarely seen（0/11） in papillary renal cell carcinoma（PRCC） tumor, with clear boundary in unenhanced CT （ 11/11 ） and homogeneous enhancement （6/11） . In CCRCC tumor, necrosis or cystic degeneration was commonly seen （17/44）, with unclear boundary in unenhanced CT （20/44）and heterogeneous enhancement （35/44）. The enhanced density value of the two periods and enhanced degree value of lesion were lower in PRCC than in CCRCC. Conclusion PRCC and CCRCC （less than or equal to 3cm） could be differentially diagnozed.