螺旋CT对肾透明细胞癌与乏脂肪血管平滑肌脂肪瘤的诊断价值

Application value of spiral CT in diagnosis of renal clear cell carcinoma and lack of fat angiomyolipomas

目的分析肾透明细胞癌(ccRCC)与乏脂肪血管平滑肌脂肪瘤(RAml)螺旋CT的特征,研究螺旋CT对两种疾病的诊断价值。方法对接受螺旋CT扫描的ccRCC患者22例(A组)以及乏脂肪RAml患者18例(B组)的数据进行回顾性分析。分别对比2组CT值、基本资料以及形态特征情况。结果 A组年龄、病灶大小高于B组,A组单发人数占比为100%(22/22),高于B组的61.11%(11/18),具有显著性差异(均P<0.05)。A组皮质期、肾盂期CT值均高于B组,差异均有统计学意义(P<0.05)。A组坏死囊变、假包膜人数占比均高于B组,而剪刀征、皮质翘起征、合并出血以及黑点征人数均低于B组,差异有统计学意义(P<0.05)。A组绝大多数为不均匀强化,占比为77.27%(17/22),B组均匀强化稍多,占比为55.56%(10/18),差异有统计学意义(P<0.05)。薄层重建B组8例发现微脂肪区域,占比为44.44%(8/18),而A组未发现微脂肪区域,差异有统计学意义(P<0.05)。结论螺旋CT对ccRCC与乏脂肪RAml的诊断价值较高,值得临床推广应用。

Objective To investigate the spiral CT features of renal clear cell carcinoma（ ccRCC） and lack of fat angiomyolipomas（ RAml）,and to explore its diagnostic value for the two kinds of diseases. Methods The data of spiral CT scanning about 2 patients with ccRCC（ group A） and 18 patients with Raml（ group B） who were dianosed in our hospital from February 2012 to November 2016 were retrospectively analyzed. The CT value and morphological characteristics,basic data were statistical analyzed and compared between two groups. Results The patient＇s age and the lesion size in group A were significantly higher than those in group B（ P〈 0. 05）. The single number of people in group A accounted for 100%（ 22/22）,which was significantly higher than [61. 11%（ 11/18） ]in group B（ P 〈0. 05）. The CT values at cortex stage,pelvic stage in group A were（ 133. 5 ± 34. 8） Hu,（ 153. 2 ± 37. 5） Hu,respectively,which were significantly higher than those in group B（ P 〈0. 05）. Moreover the necrosis capsule lesion and the number of pseudocapsule in group A were significantly higher than those in group B,however,the patient numbers with scissors sign,cortex cocking sign,combined bleeding and macula sign in group A were significantly lower than those in group B（ P〈 0. 05）. In addition the patients in group A were mostly heterogeneous enhancement,howeverr,the patients in group B were substantially uniform strengthening（ P 〈0. 05）. TLC reconstruction showed there were 8 cases of micro fat areas in group B（ 44. 44%）,however,no case was observed in group A,there were significant differences between two groups（ P〈 0. 05）. Conclusion Spiral CT has important value in diagnosis of ccRCC and lack of fat RAml,therefor,which is worthy of clinical popularization and application.