256排螺旋CT鉴别诊断乏脂性肾血管平滑肌脂肪瘤和非透明细胞肾癌的价值分析-《中国医学物理学杂志》

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Title:: Value of 256-slice spiral CT in the differential diagnosis of renal angiomyolipoma with minimal fat and non-clear cell renal cell carcinoma

文章编号:: 1005-202X（2020）12-1520-05

作者:: 何小红1; 纪久雨2; 陈英杰3; 1.东南大学附属中大医院江北院区放射科，江苏南京 210044； 2.东南大学附属中大医院江北院区麻醉科，江苏南京 210044； 3.东部战区总医院（原八一医院）消化科，江苏南京 210000

Author(s):: HE Xiaohong1; JI Jiuyu2; CHEN Yingjie3; 1. Department of Radiology, Zhongda Hospital of Southeast University (JiangBei), Nanjing 210044, China 2. Department of Anesthesiology, Zhongda Hospital of Southeast University (JiangBei), Nanjing 210044, China 3. Department of Gastroenterology, General Hospital of Eastern Theater Command, Nanjing 210000, China

关键词:: 乏脂性肾血管平滑肌脂肪瘤; 非透明细胞肾癌; 螺旋CT; 鉴别诊断

Keywords:: Keywords: renal angiomyolipoma with minimal fat non-clear cell renal cell cancer (nccrcc) spiral differential diagnosis

分类号:: R737.11；R816

DOI:: DOI:10.3969/j.issn.1005-202X.2020.12.009

文献标志码:: A

摘要:: 目的：分析256排螺旋CT鉴别诊断乏脂性肾血管平滑肌脂肪瘤（AMLmf）和非透明细胞肾癌（nccRCC）的价值。方法：回顾性分析2015年1月至2019年6月东南大学附属中大医院收治的98例患者，其中AMLmf患者33例（AMLmf组），nccRCC患者65例（nccRCC组）。所有患者采用256排双源CT系统进行腹部平扫和双期增强CT检查，进行CT特异征象“蛋筒征”的判定及CT密度值的判定。结果：AMLmf组患者出现“蛋筒征”的几率（87.879%）明显高于nccRCC组患者（3.077%），两组比较差异显著，具有统计学意义（P<0.05）。平扫时，AMLmf组的高密度比例明显高于nccRCC组，而低密度比例明显低于nccRCC组，两组比较差异显著，具有统计学意义（P<0.05）。增强扫描皮髓期时，nccRCC组患者的CT值明显高于AMLmf组，两组比较差异显著，具有统计学意义（P<0.05）；而实质期时，两组CT值比较差异较小，不具有统计学意义（P>0.05）。AMLmf组患者主要出现延时强化，而nccRCC组患者主要出现早期廓清，两组比较差异显著，具有统计学意义（P<0.05）。结论：256排螺旋CT在AMLmf和nccRCC的鉴别诊断中具有较高的价值。相较于AMLmf，nccRCC具有无“蛋筒征”、平扫密度低及增强扫描皮髓期CT值高的特性，建议行进一步大样本量研究及临床推广。

Abstract:: Abstract: Objective To analyze the value of 256-slice spiral CT in the differential diagnosis of renal angiomyolipoma with minimal fat (AMLmf) and non-clear cell renal cell carcinoma (nccRCC). Methods 98 patients, admitted to Zhongda Hospital of Southeast University from January 2015 to June 2019, were retrospectively analyzed. It includes 33 patients with AMLmf (AMLmf group) and 65 patients with nccRCC (nccRCC group). All patients underwent abdominal scan and contrast-enhanced dual-phase CT with 256-slice dual-source CT system to determine the "ice cream cone sign" (a specific signs of CT) and the CT density value. Results The incidence of “ice cream cone sign” in AMLmf group (87.879%) was significantly higher than that in nccRCC group (3.077%), and the difference between the two groups was statistically significant (P<0.05). According to scan, the proportion of high density in AMLmf group was significantly higher than that in nccRCC group, while the proportion of low density was significantly lower than that in nccRCC group. And the difference between the two groups was statistically significant (P<0.05). In corticomedullary phase of enhanced CT scan, the CT value of nccRCC group was significantly higher than that of AMLmf group, and the difference between the two groups was statistically significant (P<0.05) while in nephrographic phase, the difference between the two groups was smaller, and not statistically significant (P>0.05). The delayed enhancement was mainly observed in the AMLmf group, while the early clearance was mainly observed in the nccRCC group. And the difference between the two groups was statistically significant (P<0.05). Conclusion 256-slice spiral CT has high value in the differential diagnosis of AMLmf and nccRCC. Compared with AMLmf, nccRCC has the characteristics of no "ice cream cone sign", low scan density and high CT value in corticomedullary phase of enhanced CT scan. So, further study with large sample size and clinical popularization are recommended.

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

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