黏液性管状和梭形细胞癌与乳头状肾细胞癌的 CT 和 MRI 表现的对比研究。
Comparative study of CT and MRI appearances in mucinous tubular and spindle cell carcinoma and papillary renal cell carcinoma.
机构信息
Department of Radiology, Jiangsu Jianhu County People's Hospital, Affiliated Hospital of Nantong University, Nantong, China.
Department of Medical Imaging, Clinical Medical College, Yangzhou University, Yangzhou, China.
出版信息
Br J Radiol. 2021 Oct 1;94(1126):20210548. doi: 10.1259/bjr.20210548. Epub 2021 Sep 3.
OBJECTIVE
To explore the feasibility of CT and MRI in differentiating mucinous tubular and spindle cell carcinoma (MTSCC) and papillary renal cell carcinoma (PRCC).
METHODS
23 patients with MTSCC and 38 patients with PRCC were studied retrospectively. CT and MRI were undertaken to investigate differences in tumour characteristics.
RESULTS
23 patients with MTSCC and 38 patients with PRCC (included 15 cases Type 1,and 23 cases Type 2), tumours (mean diameter 3.7 ± 1.6 cm 4.6 ± 1.7 cm, < 0.05), cystic components (5 32, < 0.01), calcifications (3 11, > 0.05), haemorrhage (1 22, < 0.01), tumour boundaries (1 37, < 0.01), and homogeneous enhancement (20 11, < 0.01). The density of MTSCC was lower than that of PRCC, normal renal cortex ( < 0.05), except for the medulla( > 0.05). MTSCC and PRCC tumour enhancement were lower than that for normal cortex and medulla during all enhanced phases ( < 0.05). Enhancement was higher with PRCC than with MTSCC tumours during all phases ( < 0.05). On MRI, nine cases of MTSCC and 19 cases of PRCC, tumour showed homogeneous (9 3, < 0.01), heterogeneous (0 16, < 0.01), hyperintense on T1WI (0 15, < 0.01), slightly hyperintense on T2WI (9 1, < 0.01), hypointense on T2WI (0 15, < 0.05) , relatively high signal intensity was seen on DWI (9 15, > 0.05), respectively.
CONCLUSION
CT imaging features of MTSCC include isodense or hypodense mass on unenhanced CT, with unclear boundaries; however, PRCC showed mild hyperdensity, easily have cystic components. The degree enhancement of MTSCC is lower than that for PRCC. On MR, MTSCC was slightly hyperintense on T2WI, whereas PRCC was hypointense.
ADVANCES IN KNOWLEDGE
1.CT imaging features of MTSCC include isodense or hypodense mass on unenhanced CT, with unclear boundaries.2. CT imaging features of PRCC include mild hyperdensity on unenhanced CT, easily have cystic components.3. On enhanced CT, the degree enhancement of MTSCC is lower than that for PRCC. On MR, MTSCC was slightly hyperintense on T2WI whereas PRCC was heterogeneously hypointense on T2WI.
目的
探讨 CT 和 MRI 鉴别黏液性管状和梭形细胞癌（MTSCC）和乳头状肾细胞癌（PRCC）的可行性。
方法
回顾性分析 23 例 MTSCC 患者和 38 例 PRCC 患者的 CT 和 MRI 资料，观察肿瘤特征的差异。
结果
23 例 MTSCC 患者和 38 例 PRCC 患者（包括 15 例 1 型和 23 例 2 型）肿瘤直径（3.7 ± 1.6 cm vs. 4.6 ± 1.7 cm， < 0.05）、囊性成分（5 例 vs. 32 例， < 0.01）、钙化（3 例 vs. 11 例， > 0.05）、出血（1 例 vs. 22 例， < 0.01）、肿瘤边界（1 例 vs. 37 例， < 0.01）和均匀强化（20 例 vs. 11 例， < 0.01）不同。MTSCC 密度低于 PRCC 平扫密度，除髓质外均低于正常肾皮质（ < 0.05）。增强各期 MTSCC 和 PRCC 肿瘤强化程度均低于正常皮质和髓质（ < 0.05），且 PRCC 肿瘤强化程度均高于 MTSCC（ < 0.05）。MRI 上，9 例 MTSCC 和 19 例 PRCC 肿瘤 T1WI 呈均匀（9 例 vs. 3 例， < 0.01）、不均匀（0 例 vs. 16 例， < 0.01）、高信号（0 例 vs. 15 例， < 0.01），T2WI 呈稍高信号（9 例 vs. 1 例， < 0.01），T2WI 呈低信号（0 例 vs. 15 例， < 0.05），DWI 呈相对高信号（9 例 vs. 15 例， > 0.05）。
结论
MTSCC 的 CT 成像特征包括平扫时等或稍低密度肿块，边界不清；而 PRCC 平扫时呈轻度高密度，易出现囊性成分。MTSCC 的增强程度低于 PRCC。MR 上，MTSCC 在 T2WI 上呈稍高信号，而 PRCC 呈低信号。
知识进展
- MTSCC 的 CT 成像特征包括平扫时等或稍低密度肿块，边界不清。2. PRCC 的 CT 成像特征包括平扫时轻度高密度，易出现囊性成分。3. 增强 CT 上，MTSCC 的增强程度低于 PRCC。MR 上，MTSCC 在 T2WI 上呈稍高信号，而 PRCC 在 T2WI 上呈不均匀低信号。
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