Differentiation of subtypes of renal cell carcinoma on helical CT scans.
Differentiation of subtypes of renal cell carcinoma on helical CT scans.
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DOI：
10.2214/ajr.178.6.1781499
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发表时间：
2002-06-01
影响因子：
5
通讯作者：
Cho, KS
中科院分区：
文献类型：
--
作者：
Kim, JK;Kim, TK;Cho, KS
客观的。我们研究的目的是在螺旋CT扫描中区分肾细胞癌的亚型。材料和方法。我们回顾了肾细胞癌的四个亚型的CT扫描：76常规（透明细胞），19个乳头状，13个发色恐惧症和两个收集管道。在61例患者中获得了双相CT扫描（未增强，皮质囊肿和排泄相扫描），在49例中单相CT扫描（未增强和排泄相扫描）。我们比较了患者的年龄和性别。肿瘤大小；增强的程度和模式（同质，异质，主要是外围的）；存在或不存在钙化；和肿瘤的模式，包括四种亚型中的肾上腺周期变化，静脉侵袭和淋巴结肿大。传统的肾脏癌显示出比其他亚型（p <0.05）的增强功能更强：106 +/- 48 h（平均+/- SD）在排泄阶段中，在皮质甲状腺层中的平均值+/- SD和62 +/- 25小时。当使用84 h用作皮质层的临界值时，将常规肾癌与其他亚型区分开的敏感性和特异性为74％和100％，当用作排泄量中的缩小值时，将44 h用作44 h阶段。常规（84％），乳头状（74％）和收集管道（100％）肾癌倾向于表现出异质性或主要是外周的增强，而染色体肾脏癌（69％）通常表现出同质增强。钙化在乳头状（32％）和发色恐惧症（38％）肾癌中比常规肾癌（11％）（p <0,05）更为普遍。肾脏肾癌中未注意到肾上腺的变化和静脉侵袭。而两者在收集管道肾癌中很常见。为了区分肾细胞癌的亚型，增强程度是最有价值的参数。增强模式，钙化的存在或不存在以及肿瘤膨胀模式可以在鉴定肾细胞癌亚型的鉴定中起作用。
OBJECTIVE. The purpose of our study was to differentiate subtypes of renal cell carcinoma on helical CT scans.MATERIALS AND METHODS. We reviewed CT scans of four subtypes of renal cell carcinoma: 76 conventional (clear cell), 19 papillary, 13 chromophobe, and two collecting duct. Biphasic CT scans (unenhanced, corticomedullary, and excretory phase scans) were obtained in 61 patients, and monophasic CT scans (unenhanced and excretory phase scans) in 49. We compared patient age and sex; tumor size; degree and pattern (homogeneous, heterogeneous, predominantly peripheral) of enhancement; presence or absence of calcification; and tumor-spreading patterns including perinephric change, venous invasion, and lymphadenopathy in four subtypes.RESULTS. Conventional renal carcinoma showed stronger enhancement than the other subtypes (p < 0.05): 106 +/- 48 H (mean +/-SD) in the corticomedullary phase and 62 +/- 25 H in the excretory phase. The sensitivity and specificity for differentiating conventional renal carcinoma from the other subtypes were 74% and 100% when 84 H was used as the cutoff value in the corticomedullary phase and 84% and 91% when 44 H was used as the cutoff value in the excretory phase. Conventional (84%), papillary (74%), and collecting duct (100%) renal carcinomas tended to show heterogeneous or predominantly peripheral enhancement, whereas chromophobe renal carcinoma (69%) usually showed homogeneous enhancement. Calcification was more common in papillary (32%) and chromophobe (38%) renal carcinomas than in conventional renal carcinoma (11%) (p < 0,05). Perinephric change and venous invasion were not noted in chrornophobe renal carcinoma. whereas both were common in collecting duct renal carcinoma.CONCLUSION. For the differentiation of the subtypes of renal cell carcinoma, degree of enhancement is the most valuable parameter; enhancement pattern, the presence or absence of calcification, and tumor-spreading patterns can serve supplemental roles in the identification of the subtype of renal cell carcinoma.