摘要
目的探讨透明细胞乳头状肾细胞癌(CCPRCC)的影像学表现。方法分析15例CCPRCC患者CT及MRI影像特征,采用独立样本t检验比较肿瘤与肾皮质之间平扫CT值、ADC值差异。结果15例均为单发,边界清晰,大小为(3.1±1.9)cm。13例为实性肿瘤,其中11例伴囊变,2例为囊性肿瘤。4例CT平扫呈等或稍低密度,4例呈稍高密度;6例密度不均匀,1例伴细条状钙化;8例CT值为(38.4±10.6)HU,与肾皮质比较差异无统计学意义(P>0.05)。8例MRI平扫T1WI呈稍低或低信号,3例伴发结节状、灶状高信号;8例T2WI以混杂高信号为主,5例边缘见包膜;7例DWI呈稍高信号;9例肿瘤ADC值(2.22±0.30)×10-3 mm2/s高于肾皮质,两者差异具有统计学意义(P<0.05)。增强扫描13例实性肿瘤中9例呈“快进快出”强化,4例呈持续或渐进性强化;2例囊性肿瘤增强扫描呈囊壁及中心分隔强化。结论CCPRCC好发于中老年人,肿瘤易发生囊变,出血、钙化少见,弥散受限不明显,增强扫描以“快进快出”强化为主,确诊仍需依靠组织病理学。
Objective To investigate the imaging findings of clear cell papillary renal cell carcinoma(CCPRCC).Methods15 hospitalized patients with CCPRCC were retrospectively analyzed.The CT and MRI imaging features were observed and analyzed.The differences of the CT values and the ADC values between tumor and renal cortex were compared by independent sample T test.Results The 15 cases were all single lesion,with clear boundaries and the size was(3.1±1.9)cm.13 cases were solid tumors,of which 11 cases were accompanied by cystic degeneration,and another 2 cases were cystic tumors.On the coventional CT scan,4 cases showed equal or slightly low density,4 cases showed slightly higher density;6 cases had uneven density,and the other 1 case had thin striped calcification.The CT value of 8 cases of tumor was(38.4±10.6)HU,which was not compared with renal cortex significant difference(P>0.05).The conventional MRI of 8 subjects manifested a slightly hypointensity on T1WI,3 cases were accompanied by nodular and focal hyperintensity;8 cases were mainly mixed with hyperintensity on T2WI,and 5 cases were surrounded by capsules;7 cases had slight hyperintensity on DWI.9 cases had higher ADC value in the tumor(2.22±0.30)×10-3 mm2/s than that in the renal cortex,and the difference was statistically significant(P<0.05).In the enhanced scanning,9 of the 13 solid tumors showed"fast-in and fast-out"enhancement,and 4 showed continuous or progressive enhancement;2 cases of cystic tumor showed enhanced cystic wall and central separation.Conclusion CCPRCC tends to occur in middle-aged and elderly people.Tumor is prone to cystic degeneration.Hemorrhage and calcification are rare.The diffusion limitation of tumor in MRI is not obvious,and the enhancement presents to be"fast in and out".Above all,the final diagnosis relies on histopathology.
作者
陆泽华
冒炜
殷慧康
宣璐璐
张磊
耿承军
LU Zehua;MAO Wei;YIN Huikang;XUAN Lulu;ZHANG Lei;GENG Chengjun(Department of Radiology, The 904th Hospital of the Chinese People's Liberation Army Joint Logistics Support Force, Wuxi 214044, P.R.China;Department of Radiology, Zhongshan Hospital, Shanghai Fudan University, Shanghai 200032, P.R.China;Department of Pathology, Zhongshan Hospital, Shanghai Fudan University, Shanghai 200032, P.R.China)
出处
《医学影像学杂志》
2021年第4期624-628,共5页
Journal of Medical Imaging
