摘要
目的探讨CT对最大径≤4cm的肾乏脂型血管平滑肌脂肪瘤(fp-AML)与非透明细胞肾癌的鉴别诊断价值。方法回顾性收集经病理证实的fpAML33例、乳头状肾细胞癌(PRCC)22例和肾嫌色细胞癌(ChRCC)19例,分析其CT形态学、平扫及强化特点。结果fp-AML的肿瘤最大径小于PRCC及ChRCC,差异有统计学意义(P<0.05);fp-AML的劈裂征和平扫高密度发生率高于PRCC、ChRCC,差异有统计学意义(P<0.05);在平扫和增强扫描各期肿瘤CT值、皮髓质期和实质期肿瘤绝对强化CT值、皮髓质期肿瘤相对强化幅度、皮髓质期强化率及强化程度方面,fp-AML均高于PRCC及ChRCC,差异有统计学意义(P<0.05)。在肿瘤密度均匀性、钙化、囊变坏死、肿瘤中心、啤酒杯溢出征、强化方式方面,fp-AML与PRCC及ChRCC差异无统计学意义(P>0.05)。结论肿瘤最大径、劈裂征、平扫高密度和肿瘤强化特点等有助于鉴别直径≤4cm的fp-AML和非透明细胞肾癌。
Objective To investigate the CT differential diagnosis of fat-poor renal angiomyolipoma and non-clear cell renal cell carcinoma with maximum diameter≤4cm.Methods We retrospectively analyzed the CT morphological characteristics,plain scan and enhanced features of small renal mass,including 33 patients with fp-AML,22 patients with PRCC and 19 patients with ChRCC confirmed by pathology.Results The maximum tumor diameter of fp-AML was smaller than that of PRCC and ChRCC with statistical significance(P<0.05).The incidence of angular interface and high density in fp-AML were higher than PRCC and ChRCC(P<0.05).fp-AML was higher than PRCC and ChRCC in CT value of unenhanced and each enhanced phase,absolute enhanced CT value of tumor in corticomedullary and nephrographic phases,the corticomedullary phase enhancement rate and enhancement degree,with statistical significance(P<0.05).There were no statistical difference among fp-AML,PRCC and ChRCC in density uniformity,calcification,cystic necrosis,location of the tumor center,overflowing beer sign,and enhancement pattern(P>0.05).Conclusion The maximum tumor diameter,angular interface,high density and tumor enhancement characteristics are helpful to distinguish fp-AML with diameter≤4cm from non-clear cell RCC.
作者
林丽丹
胡雅诺
邱思凡
柯志虹
许尚文
LIN Li-dan;HU Ya-nuo;QIU Si-fan;KE Zhi-hong;XU Shang-wen(Fuzong Clinical Medical College of Fujian Medical University,Fuzhou 350025,Fujian Province,China;Department of Radiology,The 900th Hospital of Joint Logistic Support Force,Fuzhou 350025,Fujian Province,China)
出处
《中国CT和MRI杂志》
2024年第1期107-109,113,共4页
Chinese Journal of CT and MRI
基金
福建省自然科学基金资助项目(2019J01524)。
关键词
血管平滑肌脂肪瘤
肾细胞癌
乳头状肾细胞癌
肾嫌色细胞癌
体层摄影术
X线计算机
鉴别诊断
Angiomyolipoma
Carcinoma
Renal Cell
Papillary Renal Cell Carcinoma
Chromophobe Renal Cell Carcinoma
Tomography
X-Ray Computed
Diagnosis
Differential
