肾嗜酸细胞腺瘤和肾嫌色细胞癌的MRI特征及鉴别诊断

MRI features and differential diagnosis of renal oncocytoma and chromophobe renal cell carcinoma

目的对比分析肾嫌色细胞癌(CRCC)和肾嗜酸细胞腺瘤(RO)的MRI表现,提高对两者鉴别诊断水平。方法回顾性分析经手术病理证实的16例CRCC和13例RO患者的MRI图像资料,两组患者均行常规MRI平扫、增强及DWI扫描,各影像特征的比较采用两样本均数的曼-惠特尼U检验,ADC值一致性检验采用Kappa检验。结果 RO和CRCC中央瘢痕(P=0.0320)、反转强化(P=0.0123)、皮质期明显强化(P=0.0152)两组间比较有统计学意义,RO和CRCC的ADC均值分别为(1.579±0.218)×10-3mm2/s和(1.290±0.256)×10-3mm2/s;ADC值差异有统计学意义(P<0.05);病灶大小、位置、有无邻近侵犯等征象无统计学意义(P>0.05)。结论 MRI特征如中央瘢痕、反转强化、皮质期强化程度以及ADC值对CRCC和RO的鉴别诊断有一定价值。

Objective The purpose of this study was to retrospectively compare the MRI features between renal oncocytoma （RO） and chromophobe renal cell carcinoma （CRCC） and to improve the accuracy of differential diagnosis. Methods All cases were confirmed by operation and pathology. The MRI features of CRCC and RO were compared. The results were analyzed with Mann-Whitney U test and Bland-Altman test. Results There were significant differences in central scar, segmental enhancement inversion, signal in cortical phase and the value of the ADC of diffusion-weighted imaging （ P 〈 0.05）. There were no significant differences in the other MRI features such as size, location and invasion of adjacent structure between the two groups （ P 〉 0. 05）. Conclusion The MRI features such as central scar, enhancement in cortical phase, segmental enhancement inversion, and the value of the ADC of diffusion-weighted imaging had certain value in the differentiating CRCC from RO.