动态增强CT扫描对肾嫌色细胞癌的诊断价值

目的评价动态增强 CT 扫描对肾嫌色细胞癌的诊断价值.资料与方法回顾性分析13例经手术病理证实的肾嫌色细胞癌的 CT 影像资料,包括瘤体平扫、增强各期 CT 值的测量,强化程度及方式(均匀、不均匀或周边强化)的判断,并观察肿瘤有无钙化、囊变、外侵及转移(肾周改变、静脉癌栓及淋巴结转移).结果13例肾嫌色细胞癌中,6例肿瘤呈均匀软组织密度,5例肿瘤显示钙化,2例肿瘤出现囊变.动态增强 CT 扫描皮髓期(CMP)和肾实质期(NP)肿瘤平均 CT 值分别为(70.23±16.55)Hu、(80.38±21.85)Hu,两者差异无统计学意义(P >0.05),但所有病灶密度均明显低于肾皮质(P <0.05);NP 瘤体强化程度明显低于周围正常肾实质(P <0.05).6例瘤体可见均匀强化,5例可见中心瘢痕,其中1例可见轮辐状强化.结论肾嫌色细胞癌的动态增强 CT 表现有一定特征性,均匀强化结合钙化及瘢痕表现有助于诊断及鉴别诊断.

Value of Dynamic Enhanced CT Scan in Diagnosing Chromophobe Renal Cell Carcinoma

Purpose To evaluate the dynamic enhanced CT scan in diagnosing chromophobe renal cell carcinoma (CRCC). Materials and Methods 13 patients with pathology proven CRCC underwent plain and multi-phase contrast enhanced CT scan. Imaging findings, including CT values, degree and enhancement (homogeneous, inhomogeneous or rim enhancement), calcification, cystic change, invasion and metastasis (perinephric lesions, venous tumor thrombus and lymph node metastasis) were analyzed retrospectively. Results The density of the tumor was homogeneous in 6 cases. Calcification was found in 5 cases and cystic change was revealed in 2 cases. On dynamic contrast enhanced CT, the mean CT values of tumors at corticomedullary phase (CMP) and nephrographic phase (NP) were (70.23±16.55) Hu, (80.38±21.85) Hu, respectively. At CMP, the mean CT value of tumors was similar to the normal renal medulla (P > 0.05), but lower than that of normal renal cortex (P < 0.05). At NP the mean CT value of the tumors was lower than normal renal parenchyma (P < 0.05). 6 tumors were homogeneously enhanced; 5 tumors were identified to have hypo-density central scar, and 1 case had spoke-wheel-like enhancement in the central area. Conclusion CRCC has some characteristic features on dynamic enhancement CT scan. Homogeneous enhancement combined with other features such as calcification and scars can help with diagnosis and differential diagnosis.