囊性肾癌CT和MRI影像学诊断研究

CT and MRI Imaging Diagnosis Research of Cystic Renal Cell Carcinoma

目的对比囊性肾癌CT和MRI影像学诊断效能。方法选定云南省曲靖市第一人民医院2018年8月-2020年8月收治的60例疑似囊性肾癌患者,分别给予CT与MRI诊断,将手术病理诊断结果作为此次研究的金标准,对比CT、MRI诊断准确率、灵敏度、特异度,Kappa检验CT、MRI与金标准的一致性,并分析CT与MRI的影像学特征:增强表现、信号改变、囊壁形态、密度。结果60例患者经手术病理诊断,确诊56例为囊性肾癌。MRI确诊55例、CT确诊46例。MRI诊断准确率(91.67%)、灵敏度(92.86%)、特异度(75.00%)均高于CT(76.67%、78.57%、50.00%),差异均具有统计学意义(P<0.05)。Kappa检验CT与金标准的一致性一般(Kappa值=0.585),MRI与金标准的一致性较好(Kappa值=0.769)。结论MRI可提高囊性肾癌诊断准确率,对于治疗方案的制定具有重要的指导意义。

Objective To compare diagnostic effect of CT and MRI in cystic renal cell carcinoma.Methods The paper chose 60 patients with suspected cystic renal cell carcinoma treated in Qujing City The First People's Hospital from August 2018 to August 2020,treated with CT and MRI diagnosis respectively.With gold standard of surgical and pathological diagnosis results,diagnostic accuracy,sensitivity and specificity of CT and MRI was compared.Consistency between CT,MRI and gold standard was tested by Kappa,and imaging characteristics of CT and MRI was analyzed,including enhancement performance,signal change,cyst wall shape density.Results After operation pathological diagnosis,56 cases were diagnosed as cystic renal cell carcinoma,55 cases were diagnosed by MRI and 46 cases by CT,diagnostic accuracy(91.67%),sensitivity(92.86%)and specificity(75.00%)of MRI was higher than CT(76.67%,78.57%and 50.00%).Difference was statistically significant(P<0.05).Kappa test showed that consistency between CT and gold standard was general(kappa value=0.585),and consistency between MRI and gold standard was better,(kappa value=0.769).Conclusion MRI can improve diagnostic accuracy of cystic renal cell carcinoma and has important guiding significance for formulation of treatment scheme.