文章摘要

CT三期动态增强扫描对早期肾透明细胞癌的诊断价值

作者: 1杨孺牛, 1刘向东, 1吴平
1 南通大学附属海安人民医院影像科,江苏 南通 22660
通讯: 杨孺牛 Email: fghwzx730@163.com
DOI: 10.3978/j.issn.2095-6959.2019.12.025

摘要

目的:探讨早期肾透明细胞癌(renal clear cell carcinoma,ccRCC)诊断和鉴别诊断中应用CT多期动态增强扫描的临床价值。方法:收集并回顾分析本院收治的52例ccRCC患者的临床资料和影像学资料,比较分析52例ccRCC患者平扫、皮髓质期、肾实质期及排泄期I~II级ccRCC的强化程度及强化模式;并以手术或病理学活检结果为标准,比较CT平扫和CT三期动态增强扫描的诊断价值。结果:I级和II级ccRCC的平扫CT值差异无统计学意义(P>0.05)。增强扫描皮髓质期、肾实质期及排泄期,II级ccRCC的CT值(Hu)均高于I级ccRCC(均P<0.05)。I级ccRCC均匀强化相对更常见,II级ccRCC不均匀强化相对更常见。此外,CT平扫准确诊断患者例数为39例,准确诊断率为75%,明显低于三期动态增强扫描98.08%(51/58),差异具有统计学意义(P<0.05)。结论:螺旋CT三期动态增强扫描对于早期ccRCC的分期鉴别有应用价值,I级与II级ccRCC在强化程度和强化模式上差异均有统计学意义,其可用于辅助进行术前分期及治疗方案选择。相较CT平扫,CT三期动态增强扫描对ccRCC的准确诊断率更高。
关键词: 肾透明细胞癌;CT三期动态增强扫描;诊断价值

Diagnostic value of CT three-phase dynamic enhanced scan in early renal clear cell carcinoma

Authors: 1YANG Runiu, 1LIU Xiangdong, 1WU Ping
1 Department of Radiology, Hai’an People’s Hospital, Nantong University, Nantong Jiangsu 226600, China

CorrespondingAuthor: YANG Runiu Email: fghwzx730@163.com

DOI: 10.3978/j.issn.2095-6959.2019.12.025

Abstract

Objective: To investigate the clinical value of multi-phase dynamic contrast enhanced CT in the diagnosis and differential diagnosis of early stage renal clear cell carcinoma (ccRCC). Methods: The clinical data and imaging data of 52 ccRCC patients admitted to our hospital were collected and retrospectively analyzed. The enhancement degree and enhancement mode of 52 ccRCC patients in plain scan, corticomedullary phase, renal parenchymal phase and excretory phase in I–II stage patients were compared and analyzed. The results of operation or pathological biopsy were used as the criteria to compare the diagnostic value between plain CT scan group and three-stage dynamic enhanced CT scan group. Results: There was no significant difference in the plain scan group between I and II ccRCC (P>0.05). The CT values(HU)of phase II ccRCC were all higher than those of phase I CCRCC in corticomedullary phase, renal parenchymal phase and excretion phase (P<0.05). Homogeneous enhancement is more common in stage I ccRCC, while heterogeneous enhancement is more common in II phase ccRCC. In addition, 39 patients were accurately diagnosed accurately by CT plain scan, the accurate diagnosis rate was 75%, which was significantly lower than the 98.08% (51/58) of the three-phase dynamic contrast-enhanced scan (P<0.05). Conclusion: In early ccRCC, three-phase dynamic contrast-enhanced spiral CT scanning is valuable for the stage identification. There are significant differences in the degree and mode of enhancement between phase I and phase II ccRCC, which can be used to assist in preoperative staging and treatment options. Compared with unenhanced scans, three-phase dynamic enhanced CT scan presented higher diagnostic accuracy for early stage ccRCC.
Keywords: renal clear cell carcinoma; CT three phase dynamic enhanced scanning; diagnostic value