| 摘要: |
| 目的 探讨超声与多层螺旋CT对肾嗜酸细胞腺瘤及嫌色细胞癌的鉴别诊断价值。方法：回顾性分析经手术及病理证实的45例嫌色细胞癌和30例肾嗜酸细胞腺瘤临床资料,研究时间为2017年2月至2020年10月,均予以超声与多层螺旋CT检查,对比肾嗜酸细胞腺瘤与嫌色细胞癌的CT征象,观察平扫、皮质期、实质期、排泄期等时期的LKR值、△AT、△TTP、△PI,以及分析各期LKR值、△AT、△TTP、△PI、联合诊断的ROC曲线。结果 常规超声表现：肾嗜酸细胞腺瘤与嫌色细胞癌在病灶性质、回声、形态及边界比较中,差异无统计学意义(P＞0.05)。超声造影表现：肾嗜酸细胞腺瘤与嫌色细胞癌在增强方式、减退方式比较中,差异无统计学意义(P＞0.05)； 肾嗜酸细胞腺瘤与嫌色细胞癌在峰值强度、增强均匀度、假包膜、△AT、△TTP、△PI比较中存在统计学意义(P＜0.05)。CT征象分析可见,肾嗜酸细胞腺瘤与嫌色细胞癌在星芒状瘢痕、均匀强化比较中存在统计学意义(P＜0.05)； 肾嗜酸细胞腺瘤与嫌色细胞癌在囊变、坏死、钙化、包膜、轮辐状强化、节段性增强反转、出血所占比中差异无统计学意义(P＞0.05)。肾嗜酸细胞腺瘤与肾嫌色细胞癌的平扫LKR值比较,差异无统计学意义(P＞0.05)；肾嗜酸细胞腺瘤皮质期、实质期及排泄期的LKR值高于肾嫌色细胞癌(P均＜0.05)。ROC曲线分析显示,多层螺旋CT中平扫、皮质期、实质期、排泄期的LKR AUC值分别为(0.525、0.931、0.800、0.850,P＜0.05)；△AT、△TTP、△PI的AUC值分别为(0.990、0.673、0.909,P＜0.05)；联合诊断的AUC值为(0.955,P＜0.05)。结论 超声与多层螺旋CT在嫌色细胞癌诊断中均具有较高的预测价值,尤其是超声造影,能为肾嗜酸细胞腺瘤和嫌色细胞癌的鉴别提供重要信息,但为了避免漏诊情况发生,建议上述两种方法临床联合诊断。 |
| 关键词: 超声 多层螺旋CT 肾嗜酸细胞腺瘤 嫌色细胞癌 鉴别 |
| DOI： |
| 投稿时间：2021-06-03修订日期：2021-08-06 |
| 基金项目: |
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| The value of ultrasound and multi-slice spiral CT in the differential diagnosis of renal eosinophilic adenoma and chromophobe cell carcinoma |
| Zhu Haibin,Du Meijun,Zhu Huiqun,Kaiwen Fu |
| (Yongkang Ruizhen Hospital) |
| Abstract: |
| Objective To investigate the value of ultrasound and multi-slice spiral CT in the differential diagnosis of renal eosinophilic adenoma and chromophobe cell carcinoma. Methods The clinical data of 45 cases of chromophobe cell carcinoma and 30 cases of renal eosinophilic adenoma confirmed by surgery and pathology were retrospectively analyzed. The study period was from February 2017 to October 2020. Both ultrasound and multi-slice spiral CT were performed. Compare the CT signs of renal eosinophilic adenoma and chromophobe cell carcinoma, observe the LKR value, △AT, △TTP, △PI of the plain scan, cortical phase, parenchymal phase, and excretion phase, and analyze the LKR value of each phase, ROC curve of △AT, △TTP, △PI, combined diagnosis. Results Routine ultrasound findings: renal eosinophilic adenoma and chromophobe cell carcinoma had no significant difference in the nature, echo, morphology and boundary of the lesion (P>0.05).Contrast-enhanced ultrasound findings: There was no statistically significant difference between renal eosinophil adenoma and chromophobe cell carcinoma in the enhancement mode and the decrease mode (P>0.05);Renal eosinophilic adenoma and chromophobe cell carcinoma had statistical significance in peak intensity, enhancement uniformity, pseudocapsule, △AT, △TTP, and △PI (P＜0.05).CT analysis showed that renal eosinophilic adenoma and chromophobe cell carcinoma were statistically significant in the comparison of star-shaped scars and uniform enhancement (P＜0.05); renal eosinophilic adenoma and chromophobe cell carcinoma were in cystic change There was no statistically significant difference in the proportions of, necrosis, calcification, capsule, spoke-like enhancement, segmental enhancement reversal, and bleeding (P>0.05).There was no significant difference in the LKR values of renal eosinophil adenoma and renal chromophobe cell carcinoma (P>0.05); the LKR values of renal eosinophil adenoma in cortical, parenchymal and excretory phases were higher than those in renal chromophobe cell carcinoma Chromophobe cell carcinoma (all P＜0.05).ROC curve analysis showed that the LKR AUC values of plain scan, cortical phase, parenchymal phase, and excretion phase in multi-slice spiral CT were (0.525, 0.931, 0.800, 0.850, P<0.05); △AT, △TTP, △PI The AUC values were (0.990, 0.673, 0.909, P<0.05); the AUC value of the combined diagnosis was (0.955, P<0.05). Conclusion Both ultrasound and multi-slice spiral CT have high predictive value in the diagnosis of chromophobe cell carcinoma, especially contrast-enhanced ultrasound, which can provide important information for the differentiation of renal eosinophilic adenoma and chromophobe cell carcinoma, but in order to avoid missed diagnosis If it occurs, it is recommended that the above two methods be combined clinically for diagnosis. |
| Key words: ultrasound multi-slice spiral CT renal eosinophil adenoma chromophobe cell carcinoma differentiation |
