AML、ccRCC患者临床、MSCT特征对比及其临床应用价值分析

Comparison of Clinical and MSCT Characteristics of AML and ccRCC Patients and Analysis of Their Clinical Application Value

目的分析肾血管平滑肌脂肪瘤(AML)、肾透明细胞癌(ccRCC)患者临床、多层螺旋CT(MSCT)特征对比及其临床应用价值。方法回顾性分析本院2015年2月至2020年7月收治且经穿刺活检或手术确诊的13例AML和54例ccRCC患者的临床资料,分析内容包括患者大小、性别、平均年龄、肿瘤直径、形态、密度、性质等CT和临床特征;比较AML和ccRCC各扫描实相CT值。结果AML患者女性居多,肿瘤最大直径较ccRCC小,肿瘤性质以实性为主,密度多均匀,坏死、劈裂征、肿瘤内血管影及假包膜均较ccRCC少见,无囊变和钙化,肿瘤边界多清晰,平扫病灶主要表现为高密度,而ccRCC平扫病灶主要表现为等密度,AML与ccRCC上述CT特征比较有明显差异(P<0.05)。两者肿瘤部位、平均年龄、生长方式及形态比较无差异(P>0.05);AML组皮质期及肾盂期CT值均低于ccRCC组(P<0.05)。结论MSCT可有效显示AML和ccRCC的影像学特征,结合患者影像学资料进行综合分析,有利于提高鉴别诊断AML和ccRCC水平。

Objective To analyze the clinical features and multi-slice spiral CT(MSCT)features of patients with renal angiomyolipoma(AML)or clear cell renal cell carcinoma(ccRCC),and to compare their clinical application value.Methods The clinical data of 13 cases of AML and 54 cases of ccRCC admitted to our hospital from February 2015 to July 2020 and confirmed by puncture biopsy or surgery were analyzed retrospectively.The CT and clinical characteristics of the patients such as age,gender,average age,tumor diameter,shape,density,and nature were analyzed.The CT values of AML and ccRCC in each scan were compared.Results The majority of AML patients are women.The largest diameter of the tumor are smaller than those with ccRCC.The nature of the tumor is mainly solid,and the density is more uniform.Necrosis,cleavage signs,vascular shadows,and pseudocapsules in tumors are less common than those of ccRCC patients,without cystic changes and calcification,and the boundaries of tumorare clear.The plain scan of the lesion mainly shows high density,while the plain scan of the lesion of ccRCC mainly shows equal density.There was a significant difference in the aove CT features between AML and ccRCC(P<0.05).There was no difference in tumor location,the average age,growth pattern,and shape between them(P>0.05).The CT values of the AML group in the cortical and renal pelvis phases were lower than those in the ccRCC group(P<0.05).Conclusion MSCT can effectively display the imaging characteristics of AML and ccRCC,and combining the patient's imaging data for comprehensive analysis is helpful to improve the differential diagnosis of AML and ccRCC.