64排螺旋CT多期增强扫描在肾癌诊断中的应用价值

Value of 64-row spiral CT multi-phase enhanced-scan in diagnosis of renal carcinomas

目的:探讨64排螺旋CT多期增强扫描在不同分期、分型肾癌诊断中的应用价值,为临床合理选择诊断方式提供依据。方法:回顾性分析某院2016年5月至2017年9月收治的经病理确诊为肾癌的患者84例,术前均行64排螺旋CT平扫及多期增强扫描,对比分析螺旋CT分期、分型与手术病理分期、分型结果,比较不同亚型肾癌患者各期CT值差异。采用SPSS 19.0统计软件进行统计学分析。结果:螺旋CT与手术病理分期结果具有较高的一致性(Kappa=0.809,P=0.000),螺旋CT与手术病理分型结果具有较高的一致性(Kappa=0.819,P=0.000)。乳头细胞癌平扫期CT值明显高于透明细胞癌与嫌色细胞癌,差异有统计学意义(P<0.05);透明细胞癌增强扫描各期CT值均明显高于乳头细胞癌和嫌色细胞癌,差异有统计学意义(P<0.05)。结论:64排螺旋CT多期增强扫描在不同分期、分型肾癌诊断上具有重要价值,可为临床术前早期诊断肾癌提供可靠依据,是术前评估肾癌分期与分型的理想手段之一。

Objective To investigate the values of 64-row spiral CT multi-phase enhanced-scan in diagnoses of different stages and types of renal carcinomas,and to provide a basis for clinical rational selection of renal cancer diagnosis.Methods Totally 84 cases of renal carcinoma patients treated in the oncology department of Shanghai Pudong New Area People's Hospital from May 2016 to September 2017 were retrospectively analyzed.All the patients received Philips Brilliance 64-row spiral CT multi-phase enhanced-scan;the results of spiral CT staging and typing were compared and analyzed with the postoperative pathological staging and typing results.Then the differences of CT values in different subtypes of renal carcinoma patients at different stages were compared.Data processing was performed using SPSS 19.0 statistical software.Results There was high consistencies between the results by spiral CT and postoperative pathological method when used for staging(Kappa=0.809,P=0.000)and typing(Kappa=0.819,P=0.000);the CT value in plain scanning of papillary cell carcinoma was higher than those of the clear cell carcinoma and chromophobe carcinoma(P<0.05);the CT value in enhanced-scan of the clear cell carcinoma was higher than those of the other two subtypes(P<0.05).Conclusion 64-row spiral CT multi-phase enhanced-scan is of value for diagnoses of different stages and types of renal carcinoma,which can provide a reliable basis for the early diagnosis of renal carcinoma,and can be used as a method for the preoperative assessment of renal carcinoma staging and typing.