不同勾画感兴趣区方法鉴别肾富血供良、恶性小肿瘤

目的 评估不同勾画ROI方式对于鉴别肾富血供良、恶性肿瘤的价值。方法 回顾性分析经病理证实的88例肾富血供小肿瘤的术前腹部CT。其中肾细胞癌（RCC）62例（RCC组），包括60例肾透明细胞癌（CCRCC）和2例肾嫌色细胞癌（CCRC）；26例良性肿瘤（良性组），包括24例乏脂肪型肾血管平滑肌脂肪瘤（MFAML）和2例肾嗜酸细胞腺瘤（RO）。分别采用传统方法（tROI，50~100 mm²）及小ROI法（sROI，10~20 mm²）勾画ROI，测量并比较组间CT值相关参数；针对差异有统计学意义的参数绘制其鉴别RCC与良性肾肿瘤的受试者工作特征（ROC）曲线，评价其诊断效能。结果 以tROI法测量的RCC组的皮质期净强化值及相对强化值均高于良性组（P均<0.05），其鉴别RCC与良性肾肿瘤的ROC曲线下面积（AUC）分别为0.692及0.667；以sROI法测量的RCC组皮质期CT值、实质期CT值、皮质期和实质期净强化值及相对强化值均高于良性组（P均<0.05），其AUC分别为0.783、0.748、0.837、0.815、0.841及0.812。结论 相比tROI法，采用sROI法测量CT值定量参数对于鉴别肾富血供良、恶性肿瘤具有更高价值。

Different method of delineating region of interest for differential diagnosis of benign and malignant hypervascular small renal tumors

Objective To explore the value of tracing ROI in differential diagnosis of benign and malignant hypervascular small renal tumors. Methods Preoperative abdominal CT of 88 patients with small benign and malignant hypervascular renal tumor confirmed pathologically were retrospectively analyzed. The patients were divided into renal cell carcinoma (RCC) group (RCC group, n=62, including 60 cases of clear cell RCCCCRCC] and 2 cases of chromophobe RCCCCRC]) and benign group (n=26, including 24 cases of angiomyolipoma with minimal fatMFAML] and 2 cases of renal oncocytomaRO]). ROI were delineated using traditional method (tROI, 50-100 mm²) and small ROI method (sROI, 10-20 mm²), respectively, and the related parameters of CT values were measured and compared between groups. The receiver operating characteristic (ROC) curve of parameters being statistically different between groups were drawn for identifying RCC and benign renal tumors, and the diagnostic efficacies were evaluated. Results The net enhancement value and relative enhancement value of cortical phase (CP) of RCC group measured with tROI were higher than those of benign group (both P<0.05), and the area under the curve (AUC) for distinguishing RCC and benign renal tumors was 0.692 and 0.667, respectively. However, CT values of CP, parenchymal phase (PP), net enhancement values of CP and PP and relative enhancement values of CP and PP measured with sROI in RCC group were all higher than those in benign group (all P<0.05), and the corresponding AUC was 0.783, 0.748, 0.837, 0.815, 0.841 and 0.812, respectively. Conclusion Compared with tROI method, quantitative parameters of CT values measured with sROI had better diagnostic value in differentiating benign and malignant hypervascular renal tumors.