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目的对比分析肾脏嫌色细胞癌(CCRC)和嗜酸细胞腺瘤(RO)的CT表现,提高鉴别诊断水平。方法回顾性分析经病理证实的15例CCRC和8例RO患者的影像学资料,对比分析其CT特征,并进行Fisher精确检验。结果 (1)所有病例均为单发,CCRC中1例见囊变坏死,2例见钙化,1例见中央瘢痕,11例显示假包膜;RO中2例见囊变坏死,3例见钙化,4例见中央瘢痕,2例显示假包膜。(2)所有肿瘤平扫均为等密度;10例CCRC在皮质期密度接近于肾髓质,而6例RO密度接近于肾皮质;12例CCRC和3例RO均匀强化,1例CCRC和4例RO表现为辐轮状强化;10例CCRC为轻-中度强化,而8例RO均为明显强化。(3)CCRC和RO的CT特征如中央瘢痕、假包膜、皮质期密度、辐轮状强化和强化程度的差异有统计学意义(P<0.05),而其他CT特征的差异无统计学意义(P>0.05)。结论 CCRC和RO的CT特征如中央瘢痕、假包膜、皮质期密度、辐轮状强化方式和强化程度对其鉴别诊断有一定价值。
Objective To compare and analyze CT manifestations of renal cell carcinoma of the kidney (CCRC) and eosinophilic adenomas (RO) and to improve the differential diagnosis. Methods The imaging data of 15 cases of CCRC and 8 cases of RO confirmed by pathology were retrospectively analyzed. Their CT features were compared and analyzed by Fisher exact test. Results (1) All the cases were solitary. One case of CCRC was cystic necrosis, two cases of calcification, one case of central scar, and 11 cases of pseudocapsule. In 2 cases of RO, cystic degeneration and necrosis were seen in 3 cases Calcification, 4 cases of central scar, 2 cases showed pseudocapsule. (2) The density of all the tumors were isodense; the density of CCRC in the cortical phase was close to that of the medulla in 10 cases, and the RO density in 6 cases was close to that of the renal cortex; 12 cases of CCRC and 3 cases of RO were uniformly strengthened, 1 case of CCRC and 4 RO showed spire-like enhancement; 10 cases of CCRC mild to moderate enhancement, and 8 cases of RO were significantly enhanced. (3) The CT features of CCRC and RO, such as central scar, pseudocapsule, cortical density, spondylosis, and degree of enhancement were statistically significant (P <0.05), while other CT features had no statistical significance (P> 0.05). Conclusions The CT features of CCRC and RO such as central scar, pseudocapsule, cortical phase density, spondylosis and intensity of enhancement have some value in differential diagnosis.