目的 探讨肾嫌色细胞癌的多排螺旋CT（multi-detector spiral computed tomography，MDCT）平扫及多期增强特征。 方法 回顾性分析67例（68灶）肾嫌色细胞癌的临床资料及MDCT征象，按肿块大小分为两组（最大径≤4 cm及>4 cm组），比较两组肿块MDCT特征，计算肿块实性部分在平扫、肾皮质期、实质期及肾盂期的CT值及其与同侧邻近肾皮质CT值的比值（La0、La1、Lv1、Lp1）并分度，分析肿块的强化方式；进行统计学分析。 结果 两组肿块内出现钙化、中央瘢痕及皮质期小血管征及肿块邻近肾盏、肾盂受压、肾门血管受压推移的百分比有显著差异（均P<0.05）；肿块实性部分La1、Lv1、Lp1间有显著差异（P<0.05）；强化峰值多出现于皮髓交界期或实质期（42/68），皮质期次之（23/68），两者间有显著差异（P<0.05）。 结论 肾嫌色细胞癌的部分MDCT特征与肿块大小有关，其强化方式多样，仔细观察肿块平扫及多期增强特点，有助于术前诊断及鉴别诊断。
Abstract
Objective To investigate the plain scan and multi-phase enhancement features of renal chromophobe cell carcinoma by multi-detector spiral computed tomography (MDCT). Methods Clinical data and MDCT signs of 67 cases (68 lesions) of renal chromophobe cell carcinoma were retrospectively analyzed. They were divided into two groups according to the tumor size (group A with the maximum diameter ≤4 cm and group B with the maximum diameter of >4 cm). The MDCT characteristics of the mass in the two groups were compared. The ratio (La0, La1, Lv1, Lp1) of the CT value of the solid part of the mass in plain scan, renal cortex stage, parenchymal stage and renal pelvis stage to the CT value of the ipsilateral adjacent renal cortex (La0, La1, Lv1, Lp1) were calculated and graded, and the enhancement mode of the mass was analyzed and statistically analyzed. Results There were significant differences in the percentage of calcification, central scar and small cortical vascular signs in the tumor and the percentage of compression of calices, pelvis and portal vessels by the tumor between group A and B (all P<0.05).There were significant differences among La1, Lv1 and Lp1 in the solid part of 68 masses (P<0.05). The enhancement peak value was the most in the dermato-pith junction or parenchymal phase, accounting for 61.76% (42/68), of which followed by the cortical phase, accounting for 33.82% (23/68), and there were significant differences in the dermato-pith junction or parenchymal phase and the cortical phase (P<0.05). Conclusions The partial MDCT features of renal chromophobe cell carcinoma are related to the size of the tumor, and the enhancement methods are varied. Careful observation of plain scan features and multistage enhancement features of the tumor is helpful for preoperative diagnosis and differential diagnosis.
关键词
多期增强扫描 /
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嫌色细胞癌 /
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CT
Key words
Multi-phase enhanced scanning /
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Chromophobe cell carcinoma /
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Computed tomography (CT)
中图分类号：
R814.42
R446.8
R329
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参考文献
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基金
福建省卫生计生中青年骨干人才培养资助项目（2017-ZQN-13）
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