CT定量分析在不同亚型肾癌诊断中的作用及影像学表现研究

The role and imaging manifestations of CT quantitative analysis in the diagnosis of different subtypes of renal carcinoma

目的:研究CT值的定量分析在不同亚型肾癌诊断中的作用及影像学表现。方法:收集医院收治的56例肾癌患者临床资料,根据肾癌亚型的不同将其分为肾透明细胞癌组(30例)、乳头状肾细胞癌组(16例)和嫌色细胞癌组(10例)。比较3组患者平扫和增强后皮质期、实质期及排泄期的CT值,比较3组患者病灶大小和强化方式,分析3组患者肾癌亚型与CT影像学表现的关系。结果:3组患者在平扫期、皮质期、实质期和排泄期的CT值比较,差异有统计学意义(F=4.48,F=126.49,F=11.06,F=8.05;P<0.05)。3组患者病灶大小之间差异无统计学意义;肾透明细胞癌组患者26.67%强化均匀,显著低于乳头状肾细胞癌组(56.25%)和嫌色细胞癌组(70.00%)患者,差异具有统计学意义(x^2=7.3913,x^2=6.58;P<0.05)。肾透明细胞癌组患者坏死或囊变的概率(76.67%)高于嫌色细胞癌组患者(30.00%),差异具有统计学意义(x^2=7.3422,P<0.05);肾透明细胞癌组患者肿瘤边缘清晰概率(30.00%)低于乳头状肾细胞癌组(81.25%)和嫌色细胞癌组(80.00%)患者,差异具有统计学意义(x^2=14.4379,P<0.05)。结论:不同亚型肾癌患者的CT值及其影像学表现存在不同的差异,可通过CT值定量分析及其影像学表现为临床诊断提供参考依据。

Objective:To explore and analyze the role and imaging manifestations of quantitative analysis of computed tomography(CT)values in the diagnosis of different subtypes of renal cell carcinoma.Methods:The clinical data of 56 patients with renal carcinoma admitted in hospital were collected.According to the different subtypes of renal carcinoma,these patients were divided into renal clear cell carcinoma group(A group,30 cases),papillary renal cell carcinoma group(B group,16 cases),and chromophobe cell carcinoma group(C group,10 cases).The CT values of plain scan stage,and enhanced cortex stage,substance stage and excretion stage among three groups were compared.The lesion size and enhancement mode of the three groups were compared.The relationship between the subtypes of renal cell carcinoma and CT imaging manifestations of the three groups was further analyzed.Results:The differences of CT values at plain scan stage,cortex stage,substance stage and excretion stage among three groups were statistically significant(F=4.48,F=126.49,F=11.06,F=8.05,P<0.05),respectively.There was no significant difference in lesion size among three groups.26.67%of patients in A group was uniformly enhanced,and it was significantly lower than that in B group(56.25%)and C group(70.00%)(x^2=7.39,x^2=6.58,P<0.05),respectively.The probability of necrosis or cystic change in A group(76.67%)was significantly higher than that in C group(30.00%)(x^2=7.3422,P<0.05).The probability of carcinoma with clear margin in A group(30.00%)was significantly lower than that in B group(81.25%)and C group(80.00%)(x^2=14.4379,P<0.05),respectively.Conclusion:There are differences in CT values and imaging manifestation among different subtypes of renal carcinoma.The quantitative analysis of CT values and the imaging manifestation of renal carcinoma can provide reference for clinical diagnosis.