CT在肾脏乏脂肪血管平滑肌脂肪瘤与肾细胞癌各亚型中的鉴别诊断价值分析

Analysis of differential diagnosis value of CT in minimal fat renal angiomyolipoma and renal cell carcinoma subtypes

目的:分析CT检查在肾脏乏脂肪血管平滑肌脂肪瘤(RAML)与肾细胞癌(RCC)各亚型中的鉴别诊断价值。方法:回顾性分析10例RAML(RAML组)和30例RCC患者(RCC组)的CT影像资料。患者均行CT平扫和增强扫描。对比RAML和RCC各亚型患者的CT值与均匀强化率。结果:平扫时RAML组CT值明显大于RCC各亚型组;皮质期,RAML组CT值明显大于乳头状细胞癌组与嫌色细胞癌组,明显小于透明细胞癌组;实质期和排泄期,RAML组CT值明显大于乳头状细胞癌组和嫌色细胞癌组,差异均有统计学意义(P<0.05);实质期和排泄期,RAML组CT值与透明细胞癌组比较,差异无统计学意义(P>0.05)。RAML组均匀强化率明显高于透明细胞癌组,差异具有统计学意义(P<0.05);RAML组均匀强化率与乳头细胞癌组和嫌色细胞癌组比较,差异无统计学意义(P>0.05)。结论:CT检查在RAML与RCC各亚型鉴别诊断中具有重要意义。

Objective： To analyze differential diagnosis value of CT in minimal fat renal angiomyolipoma （RAML） and renal cell carcinoma （RCC） subtypes. Methods： The CT images of 10 patients with RAML （RAML group） and 30 patients with RCC （RCC group） were retrospectively analyzed. All patients underwent CT plain scan and enhanced scan. The CT values and uniform enhancement rates were compared among the patients with RAML and RCC subtypes. Results： In the plain scan, the CT value of the RAML group was significantly larger than that of the RCC subtype group. In the cortex phase, the CT value of the RAML group was significantly larger than that of the papillary cell carcinoma and chromophobe cell carcinoma group, and significantly smaller than that of the clear cell carcinoma group. In the parenchymal phase and the excretory phase, the CT value of the RAML group was significantly higher than that of papillary cell carcinoma and chromophobe cell carcinoma, and the differences were statistically significant （ P 〈 0.05 ）. There was no significant difference in the CT value between the RAML group and the clear cell carcinoma group in the parenchymal phase and the excretory phase （ P 〉0.05）. Further, the uniform enhancement rate of the RAML group was significantly higher than that of clear cell carcinoma group, and the difference was statistically significant （ P 〈0.05）; however, there was no significant difference in the uniform enhancement rate between the RAML group and the papillary cell carcinoma as well as between the RAML group and the chromophobe cell carcinoma group （ P 〉0.05）. Conclusions： CT examination is of great significance in the differential diagnosis of RAML and RCC subtypes.