摘要
目的探讨CT平扫征象及CT动态增强在鉴别乏脂性血管平滑肌脂肪瘤(angiomy-olipoma with minimal fat,AMLmf)与三种常见病理类型肾癌的应用价值。方法选取83例肾脏实性肿块,其中15例经病理确诊为AMLmf,15例经病理确诊为肾脏乳头状细胞癌(PRCC),27例经病理确诊为肾脏透明细胞癌(CCRCC),26例经病理确诊为肾脏嫌色细胞癌(ChRCC)。83例患者术前均行CT平扫及三期动态增强检查,分别测量肿块实性区域平扫及三期动态增强CT绝对值,随后计算平扫与增强各期之间CT绝对值,三组(乏脂性AML与乳头状细胞癌、乏脂性AML与透明细胞癌、乏脂性AML与嫌色细胞癌)病例各期CT绝对值比较行单因素方差分析;四类病例分别观察病灶平扫密度是否均匀、强化密度是否均匀、是否囊变、有无星芒状瘢痕、有无劈裂征、有无钙化,随后采用χ^(2)检验或Fisher确切概率法分析。结果AMLmf皮质期-平扫CT绝对值、排泄期-实质期CT绝对值均显著大于PRCC,实质期-皮质期CT绝对值显著小于PRCC,差异有统计学意义(P<0.05);AMLmf皮质期-平扫CT绝对值、实质期-皮质期CT绝对值、排泄期-实质期CT绝对值均显著小于CCRCC(P<0.05);AMLmf皮质期-平扫CT绝对值小于ChRCC,差异有统计学意义(P<0.05);AMLmf最大径显著小于PRCC、ChRCC,差异有统计学意义(P<0.05);在劈裂征方面,AMLmf与三种肾癌比较差异均有统计学意义(P<0.05);在强化是否均匀、有无囊变、肿瘤生长内生/外生方面,AMLmf与CCRCC比较差异有统计学意义(P<0.05),余差异无统计学意义。结论CT动态增强各期CT绝对值及CT征象有利于鉴别AMLmf及三种常见类型肾癌。
Objective To investigate the application value of plain CT and dynamic CT enhancement in differentiating angiomy-olipomas with minimal fat(AMLmf)and three common pathological types of renal carcinoma.Methods 83 cases of solid renal mass were retrospectively analyzed,among which 15 were pathologically confirmed as AMLmf,15 as PRCC of the kidney,27 as CCRCC of the kidney,and 26 as ChRCC of the kidney.All 83 patients underwent CT plain scan and phase III dynamic enhancement examination before surgery.The CT value of plain scan and dynamic enhanced CT in solid mass area were measured respectively,and then,the CT value differences between plain scan and each stage of enhanced CT were calculated.One-way ANOVA was performed for comparison of CT differences between the two groups at each stage.The uniformity of the density of plain scan,uniformity of enhanced density,cystic lesions,star and scar,splitting sign and calcification were observed in the four groups,and then,analyzed by x2 test or Fisher's exact probability method.Results The CT difference between cortical phase and plain scan and excretory phase and parenchymal phase of AMLmf was significantly higher than that of PRCC,and the CT difference between parenchymal phase and cortical phase was significantly lower than that of PRCC(P<0.05).CT difference between cortical phase and plain scan and CT value difference between parenchymal phase and cortical phase and CT value difference between excretory phase and parenchymal phase of AMLmf were significantly lower than those of CCRCC(P<0.05).There were significant differences between AMLmf and ChRCC when talking about CT value difference of plain CT and cortical phase(P<0.05).The maximum diameter of AMLmf was significantly lower than that of PRCC and ChRCC(P<0.05).There were statistically significant differences between AMLmf and the three types of renal carcinoma in cleavage sign(ALL P<0.05).There were statistically significant differences between AMLmf and CCRCC in the uniformity of enhancement and the presence of cys
作者
耿琳琳
吕英强
房中华
GENG Linlin;LYU Yingqiang;FANG Zhonghua(Department of Imaging,Zibo First Hospital,Zibo 255200,China;Department of Imaging,Zibo Hospital of Shandong HealthCare Group,Zibo 255120,China)
出处
《医学影像学杂志》
2024年第1期66-69,95,共5页
Journal of Medical Imaging
