| 双源CT对肾透明与非透明细胞癌的鉴别诊断价值 |
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| 引用本文： | 陆艳艳,陈宏伟,鲍健,方向明,邹新农,汤群峰.双源CT对肾透明与非透明细胞癌的鉴别诊断价值[J].CT理论与应用研究,2018,27(1):19-25. |
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| 作者姓名： | 陆艳艳 陈宏伟 鲍健 方向明 邹新农 汤群峰 |
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| 作者单位： | 南京医科大学附属无锡人民医院医学影像科, 江苏 无锡 214023 |
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| 摘 要： | 目的:探讨双源CT双能量成像技术在肾透明细胞癌和非透明细胞癌鉴别诊断中的应用价值。方法:选取我院2015年4月至2017年3月期间入院就诊，经超声、CT平扫怀疑肾占位性病变患者68例，所有患者均行双源CT扫描。对比分析肾透明细胞癌与非透明细胞癌双源CT成像特征，并比较肾透明细胞癌和非透明细胞癌皮髓期及实质期碘浓度和NIC（标准化碘浓度）、肾透明细胞癌不同病理分级碘浓度和NIC及双源CT双能量成像技术用于肾透明细胞癌和非透明细胞癌鉴别诊断灵敏度和特异度。结果:经手术病理确诊32例肾透明细胞癌和17例非透明细胞癌，经双源CT双能量成像技术扫描，透明细胞癌患者在皮髓期和实质期碘浓度及NIC均较非透明细胞癌患者高，组间统计差异显著（P<0.05）；肾透明细胞癌在皮髓期及实质期，低级别（Ⅰ级、Ⅱ级）肾透明细胞癌患者碘含量及NIC均显著高于高级别（Ⅲ级、Ⅳ级）组，组间比较存在显著性差异（P<0.05）。此外，分析双源CT双能量成像技术用于肾透明细胞癌和非透明细胞癌鉴别诊断灵敏度和特异度发现:以实质期NIC界值0.70为标准时，对肾透明细胞癌及非透明细胞癌鉴别诊断的灵敏度（83.67%）和特异度最高（77.55%）。结论:双源CT双能量成像技术可通过将碘定量分析技术区分肾透明细胞癌和非透明细胞癌，且具有较高的灵敏度和特异度，同时还能为肾透明细胞癌病理分级提供依据。
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| 关 键 词： | 肾透明细胞癌 双源CT双能量成像技术 鉴别诊断 |
| 收稿时间： | 2017-08-12 |
Study on Clinical Application of Dual-source CT for Differentiating Diagnosis between Renal Clear Cell Carcinoma and Non-clear Cell Carcinoma |
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| LU Yan-yan,CHEN Hong-wei,BAO Jian,FANG Xiang-ming,ZOU Xin-nong,TANG Qun-feng.Study on Clinical Application of Dual-source CT for Differentiating Diagnosis between Renal Clear Cell Carcinoma and Non-clear Cell Carcinoma[J].Computerized Tomography Theory and Applications,2018,27(1):19-25. |
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| Authors: | LU Yan-yan CHEN Hong-wei BAO Jian FANG Xiang-ming ZOU Xin-nong TANG Qun-feng |
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| Affiliation: | Department of Medical Imaging, Wuxi People's Hospital Affiliated to NJMU, Wuxi 214023, China |
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| Abstract: | Objective: To investigate the application of dual-source CT dual energy imaging technique in differential diagnosis of renal clear cell carcinoma and non-clear cell carcinoma. Methods: 68 cases of patients with suspected renal occupying lesions who received ultrasound, CT scan in our hospital from April 2015 to March 2017 were selected, all patients underwent dual-source CT scan. Comparative analysis of dual-source CT imaging features of renal clear cell carcinoma and non-clear cell carcinoma was taken, iodine concentration and NIC (normalized iodine concentration) of renal clear cell carcinoma and non clear cell carcinoma in corticomedullary phase and parenchyma phase , iodine concentration in different pathological grading and NIC of renal clear cell carcinoma were compared, sensitivity and specificity of differential diagnosis of dual source CT dual energy imaging technique used in diagnosing renal cell carcinoma and non clear cell carcinoma. Results: 32 cases who were confirmed by surgery and pathology had renal clear cell carcinoma and 17 cases had non clear cell carcinoma, after scanning of dual source CT dual energy imaging technique, the iodine concentration and NIC of patients with clear cell carcinoma in corticomedullary phase and parenchymal phase were higher than those of patients with non clear cell carcinoma, there was significant distance (P < 0.05); Iodine concentration and NIC of low grade (grade Ⅰ and Ⅱ) renal clear cell carcinoma patients in corticomedullary phase and parenchyma phase were significantly higher than those of the high grade (grade Ⅲ and Ⅳ), there was significant difference between the two groups (P < 0.05). In addition, analysis of diagnostic sensitivity and specificity of dual source CT dual energy imaging technique used in diagnosing renal cell carcinoma and non clear cell carcinoma showed: when NIC value of 0.704 was set as a standard in parenchyma phase, the differential diagnostic sensitivity (84.6％) and specificity (76.7％) of renal clear cell carcinoma and non clear cell carcinoma were the highest. Conclusion: Dual source CT dual energy imaging technique can distinguish renal cell carcinoma and non clear cell carcinoma via iodine quantitative analysis technique, it has higher zero sensitivity and specificity, can provide basis for pathologic grading of renal clear cell carcinoma. |
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