320排CT双期增强在肾细胞癌常见亚型的鉴别诊断价值

doi:10.12117/jccmi.2018.10.007

Abstract
Figure/Table
References (15)
Related Citation (15)

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To detect the value of dual-phase contrast enhancement by 320-slice CT in the differential diagnosis of common renal cell carcinoma(RCC) subtypes. Methods: The clinical data of 224 cases of RCC confirmed by pathology were retrospectively analyzed, including 196 cases of clear cell RCC, 14 cases of papillary RCC and 14 cases of chromophobe RCC. The morphology, calcification and strengthening methods of the tumor were analyzed. T test was used to compare the enhancement degree of RCC in different pathological subtypes, the CT ratio between the lesion and the abdominal aorta, and the area under the ROC curve, sensitivity and specificity were calculated. Results: Clear cell RCC commonly manifested heterogeneous, and papillary RCC were homogeneous enhancement, while chromophobe RCC were homogeneous enhancement and solid-based heterogeneous enhancement. Therefore, the possibility of clear cell RCC was suggested when the focus was cystic or cystic and solid mixture inhomogeneous enhancement(χ2=4.286, P<0.05). The enhancement degree of clear cell RCC in cortical and parenchymal phase was significantly higher than that of chromophobe RCC and papillary RCC(P<0.01). The sensitivity and specificity of single-phase contrast enhancement for discriminating clear cell RCC from papillary RCC were 87.76%～92.35%, 78.57%～85.71%, the sensitivity and specificity for discriminating clear cell RCC from chromophobe RCC were 74.49%～87.73%, 85.71%～92.86%, the sensitivity and specificity of dual-phase contrast enhancement in the differential diagnosis of clear cell RCC, papillary RCC and chromophobe RCC were 88.27%～91.33%, 85.71%～92.82%. Conclusion: While reducing ionizing radiation, dual-phase contrast enhancement by 320-slice CT is useful in differentiating clear cell RCC from other RCC subtypes.

Key words： Carcinoma, renal cell Tomography, X-ray computed

Received: 13 November 2017

PACS:	Ｒ737.11
	Ｒ814.42

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	CAI Bing
	GAO Xiao-jian
	CHEN Tan-hui

Cite this article:

CAI Bing,GAO Xiao-jian,CHEN Tan-hui. Diagnostic value of dual-phase contrast enhancement in the differential diagnosis of#br# common renal cell carcinoma subtypes by 320-slice CT[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(10): 708-712.

URL:

http://www.jccmi.com.cn/EN/10.12117/jccmi.2018.10.007 OR http://www.jccmi.com.cn/EN/Y2018/V29/I10/708

[1]Hoffmann NE, Gillett MD, Cheville JC, et al. Differences in organ system of distant metastasis by renal cell carcinoma subtype[J]. J Urol, 2008, 179(2): 474-477.
[2]Cheville JC, Lohse CM, Zincke H, et al. Comparisons of outcome and prognostic features among histologic subtypes of renal cell carcinoma[J]. Am J Surg Pathol, 2003, 27(5): 612-624.
[3]Zhang J, Lefkowitz RA, Ishill NM, et al. Solid renal cortical tumors: differentiation with CT[J]. Radiology, 2007, 244(2): 494-504.
[4]Silverman SG, Leyendecker JR, Amis ES, et al. What is the current role of CT urography and MR urography in the evaluation of the urinary tract?[J]. Radiology, 2009, 250(2): 309-323.
[5]Cohan RH, Sherman LS, Korobkin M, et al. Renal masses: assessment of corticomedullary-phase and nephrographic-phase CT scans[J]. Radiology, 1995, 196(2): 445-451.
[6]Kang SK, Kim D, Chandarana H. Contemporary imaging of the renal mass[J]. Urol Clin North Am, 2011, 12(1): 11-17.
[7]马周鹏，周建军，刘学玲. 双能CT双期增强扫描结合虚拟平扫对肾脏透明细胞癌的诊断价值[J]. 中华放射学杂志，2012，46（8）：687-692.
[8]Moch H, Cubilla AL, Humphrey PA, et al. The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours[J]. Eur Urol, 2016, 70(1): 93-105.
[9]刘学玲，周建军，陈宏伟. 双能CT双期增强扫描不同管电压图像对小透明细胞肾癌的诊断价值[J]. 中华放射学杂志，2013，47（11）：997-1001.
[10]吴晓华，杨海鹏，靳二虎. 动态增强CT扫描对常见肾细胞癌亚型的鉴别诊断价值[J]. 医学影像学杂志，2012，22（7）：1172-1177.
[11]Sheir KZ, El-Azab M, Mosbah A, et al. Differentiation of renal cell carcinoma subtypes by multislice computerized tomography[J]. J Urol, 2005, 174(2): 451-455.
[12]Herts BR, Coll DM, Novick AC, et al. Enhancement characteristics of papillary renal neoplasms revealed on triphasic helical CT of the kidneys[J]. AJR, 2002, 178(2): 367-372.
[13]Jinzaki M, Tanimoto A, Mukai M, et al. Double-phase helical CT of small renal parenchymal neoplasms: correlation with pathologic findings and tumor angiogenesis[J]. J Comput Assist Tomogr, 2000, 24(6): 835-842.
[14]Ruppert-Kohlmayr AJ, Uggowitzer M, Meissnitzer T, et al. Differentiation of renal clear cell carcinoma and renal papillary carcinoma using quantitative CT enhancement parameters[J]. AJR, 2004, 183(5): 1387-1391.
[15]Young JR, Margolis D, Sauk S, et al. Clear cell renal cell carcinoma: discrimination from other renal cell carcinoma subtypes and oncocytoma at multiphasic multidetector CT[J]. Radiology, 2013, 267(2): 444-453.