肾嫌色细胞癌CT多期强化特征表现及病理分析

Multi-phase Enhanced CT Features and Pathological Analysis of Renal Chromophobe Cell Carcinoma

目的探讨肾嫌色细胞癌(CRCC)的CT多期增强特征,以提高对该病的影像学诊断水平。方法回顾性分析29例经病理证实的肾嫌色细胞癌,分析其CT平扫、增强特征和临床表现,总结其特征性表现。结果肿瘤几乎为类圆形的等或稍低密度灶,包膜、钙化、中央疤痕发生率分别为13.79%、10.35%、13.79%,肿瘤平扫、动脉期、静脉及延迟平均CT值分别为35.773.6HU、90.1416HU、80.6422.46HU。无临床症状25例,腰酸痛4例。结论CRCC的CT多期增强具有一定的特征性,但是CT表现多样,当出现囊变、坏死时难与透明细胞癌鉴别,表现为等密度,轻度强化的实性结节时与嗜酸细胞瘤和乏脂肪型错构瘤鉴别困难。

Objective To investigate the multi-phase enhanced CT features of renal chromophobe cell carcinoma(CRCC)in order to improve its imaging diagnostic accuracy.Methods 29 cases of CRCC confirmed by pathology were analyzed retrospectively.The CT features of plain scan,enhancement and clinical features were analyzed.Results The tumors were almost round,isodense or slightly hypodense.The incidence of capsule,calcification and central scar was 13.79%,10.35%and 13.79%respectively.The mean CT values of plain scan,arterial phase,venous phase and delayed CT were 35.773.6 HU,90.1416HU,80.6422.46HU,respectively.There were 25 cases without clinical symptoms and 4 cases of flank and back pain.Conclusion Multiphase CT enhancement of CRCC has certain characteristics,but CT manifestations are various.It is difficult to differentiate CRCC from clear cell carcinoma when cystic degeneration and necrosis occur.It is difficult to differentiate CRCC from eosinophilic tumor and renal fat-poor angiomyolipoma.