Wu Jingtao, Zhu Qingqiang, Zhu Wenrong, Chen Wenxin, Wang Shouan
Department of Medical Imaging, Subei People's Hospital, Medical School of Yangzhou University, Yangzhou, PR China
Department of Medical Imaging, Subei People's Hospital, Medical School of Yangzhou University, Yangzhou, PR China.
Acta Radiol. 2016 Apr;57(4):500-6. doi: 10.1177/0284185115585035. Epub 2015 May 13.
Renal oncocytoma (RO) and chromophobe renal cell carcinoma (ChRCC) share histologic and some imaging features.
To investigate the multidetector computed tomography (MDCT) characteristics of these two tumor types.
Fifty-six patients with RO and 54 patients with ChRCC were studied retrospectively. MDCT was undertaken to investigate differences in tumor characteristics.
Calcifications were visible in 24 (42.8%) patients with RO and in 11 (20.4%) patients with ChRCC (P = 0.011). 26 patients with RO had stellate scars as did 14 patients with ChRCC (P = 0.025). Spoken-wheel-like enhancement was visible in 41 patients with RO and in 11 with ChRCC (P < 0.001). Thirty-nine (69.6%) patients with RO and nine (16.7%) patients with ChRCC showed segmental inversion (P < 0.001). Two patients with RO had retroperitoneal lymph node enlargement as did 13 patients with ChRCC (P = 0.002). Combined evaluation of stellate scar, spoken-wheel-like enhancement, and segmental enhancement inversion features were found to have a sensitivity of 99.1% (106 of 107), a specificity of 100% (3 of 3), a positive predictive value of 100% (106 of 106), and a negative predictive value of 75% (3 of 4). The attenuation of RO tumors was greater than that of ChRCC tumors, normal renal parenchyma on unenhanced CT (P = 0.031). Enhancement was higher with RO than with ChRCC tumors in all phases (P = 0.021, < 0.001, and 0.007, respectively).
CT imaging features such as stellate scar, spoken-wheel-like enhancement, and segmental enhancement inversion were more common in RO and they may help in differentiating RO from ChRCC.
肾嗜酸细胞瘤（RO）和嫌色性肾细胞癌（ChRCC）具有共同的组织学特征及一些影像学特征。
探讨这两种肿瘤类型的多排螺旋计算机断层扫描（MDCT）特征。
回顾性研究56例RO患者和54例ChRCC患者。采用MDCT研究肿瘤特征的差异。
24例（42.8%）RO患者和11例（20.4%）ChRCC患者可见钙化（P = 0.011）。26例RO患者和14例ChRCC患者有星状瘢痕（P = 0.025）。41例RO患者和11例ChRCC患者可见轮辐样强化（P < 0.001）。39例（69.6%）RO患者和9例（16.7%）ChRCC患者出现节段性强化反转（P < 0.001）。2例RO患者和13例ChRCC患者出现腹膜后淋巴结肿大（P = 0.002）。星状瘢痕、轮辐样强化和节段性强化反转特征的联合评估显示，敏感性为99.1%（107例中的106例），特异性为100%（3例中的3例），阳性预测值为100%（106例中的106例），阴性预测值为75%（4例中的3例）。RO肿瘤在未增强CT上的衰减大于ChRCC肿瘤及正常肾实质（P = 0.031）。在所有期相，RO肿瘤的强化均高于ChRCC肿瘤（分别为P = 0.021、< 0.001和0.007）。
星状瘢痕、轮辐样强化和节段性强化反转等CT成像特征在RO中更为常见，可能有助于RO与ChRCC的鉴别诊断。
