MDCT在肾盂癌和肾癌鉴别诊断中的价值

目的探讨多层螺旋CT(MDCT)三期增强扫描在肾盂癌和肾癌鉴别诊断中的价值,以期提高术前诊断的准确性。方法回顾性分析经病理证实的11例男9例,女2例;平均年龄(70.2±11.7)岁]肾盂癌及26例男21例,女5例;平均年龄(67.3±11.7)岁]肾癌,所有病人术前均行64层螺旋CT平扫及三期增强扫描。分析病人的CT表现,测量并计算病人各期肿瘤/皮质CT比值及肿瘤-皮质CT差值,并采用独立样本t检验比较2组间各期CT参数值的差异。结果肾盂癌病人动脉期及实质期的肿瘤/皮质CT比值均低于肾癌病人(均P<0.05),2组病人平扫及排泄期的肿瘤/皮质CT比值差异均无统计学意义(均P>0.05)。肾盂癌病人实质期的肿瘤-皮质CT差值低于肾癌病人(P<0.05),而2组病人平扫、动脉期及排泄期的肿瘤-皮质CT差值差异无统计学意义(均P>0.05)。结论肾盂癌及肾癌的三期增强扫描CT参数存在明显差异。肿瘤/皮质CT比值对两者具有更好的鉴别诊断能力。

Value of multidetector CT in differentiating renal pelvic carcinoma and renal carcinoma

Objective To explore the value of multidetector spiral CT (MDCT) three-phase enhanced scan in differentiating renal pelvic carcinoma and renal carcinoma, in order to improve the accuracy of preoperative diagnosis. Methods A retrospective analysis of 11 renal pelvic carcinoma cases (9 males, 2 females; mean age 70.2±11.7 years old) and 26 renal cancer cases (21 males and 5 females; mean age 67.3±11.7 years old). All cases were confirmed by pathology analysis, and all patients underwent 64-row spiral CT and three-phase enhanced scan before surgery. The patients’ CT findings were analyzed, and the CT attenuation values of tumor and cortical at different enhancement phases were measured, and their ratios (tumor/cortex) and difference (tumor-cortex) were calculated. The independent sample t test was used to compare the differences of CT indexes between the two groups. Results The tumor/cortical CT ratios at the arterial and parenchymal phases were lower in the patients with renal pelvic carcinoma than in the patients with renal cancer (both P<0.05). There was no significant difference in the tumor/cortical CT ratio between the two groups at the plain and drainage phases. P>0.05). The tumor-cortical CT value was lower in the patients with renal pelvic cancer than in the patients with renal cancer at the parenchymal phase(P<0.05), but there was no significant difference between the two groups at plain, arterial, and drainage phases (all P>0.05). Conclusion Significant differences in CT indexes exist between renal pelvis carcinomas and renal carcinomas in three-phase enhanced CT scan. The tumor/cortex CT ratio has better differential diagnostic ability.