摘要
目的通过增强CT多参数影像学特征,评估其鉴别和诊断儿童肾透明细胞肉瘤(CCSK)和肾母细胞瘤(WT)的价值。方法回顾性分析经病理证实的14例CCSK和42例WT患者资料,通过比较分析两者间的临床特征及常规的影像学特征,另外测量肾实质期肿瘤实性部分强化的最大CT值(CT_(max))与同侧竖脊肌、对侧肾静脉CT值比值(CT_(max)/CT_(肌肉)和CT_(max)/CT_(肾静脉))以减少增强CT其他因素的影响。分别采用卡方或Fisher精确概率和Mann-Whitney U检验对分类变量和连续变量进行分析,采用二元Logistic回归进行多变量的筛选,采用受试者工作特征曲线(ROC)分析各特征的鉴别价值。结果CCSK组患者出现肾周充盈血管影征象和瘤周小囊征象更为常见;与WT组相比,CCSK组的CT_(max)、CT_(min)、CT_(max)/CT_(肌肉)、CT_(max)/CT_(肾静脉)和CT_(min)/CT_(肌肉)更高。二元Logistic回归显示瘤周小囊征象和CT_(max)/CT_(肾静脉)可以作为CCSK和WT的独立鉴别因子。结论瘤周小囊征象和增强CT_(max)/CT_(肾静脉)有助于对儿童CCSK和WT的鉴别诊断。
Objective The aim of this study was to evaluate the multi-parameter imaging features of enhanced CT that could distinguish between Clear Cell Sarcoma of the Kidney(CCSK)and Wilms tumor(WT).Methods We reviewed 14 cases of pathologically confirmed CCSK and 42 cases of WT.The clinical features and conventional imaging features were compared and analyzed.In addition,the maximum density of the tumor of the enhancing solid portion,paraspinal muscle,contralateral renal vein density,and density ratios were analyzed on the renal parenchymal phase of contrast-enhanced CT to reduce the influence of other factors on the enhanced CT.Chi-square or Fisher’s exact tests and Mann-Whitney U tests were conducted to analyze the categorical and continuous variables,respectively.Multivariate screening was conducted by binary Logistic regression,and receiver operating characteristic curve(ROC)was used to analyze the discriminant value of each feature.Results Perirenal filling angiography and dilated peritumoral cyst were more common in the renal clear cell sarcoma group.Compared with WT,CCSK group had higher CT_(max),CT_(min),CT_(max)/CT_(muscle),CT_(max)/CT_(renal vein) and CT_(min)/CT_(muscle).Multiple Logistic regression showed that dilated peritumoral cyst and CT_(max)/CT_(vein)could be used as most significant distinguishing factor between WT and CCSK.Conclusion The CT features of dilated peritumoral cyst and enhancement of CT_(max)/CT_(muscle)are helpful for differentiating between CCSK and Wilms’tumor.
作者
张国勋
邱辰杰
杨青
王波
李委糠
赖灿
夏彬熊
马晓辉
ZHANG Guoxun;QIU Chenjie;YANG Qing(Department of Radiology,The Children's Hospital,Zhejiang University School of Medicine,National Clinical Research Center for Child Health,Hangzhou,Zhejiang Province 310052,P.R.China)
出处
《临床放射学杂志》
北大核心
2022年第8期1525-1529,共5页
Journal of Clinical Radiology
