Department of Imaging, Affiliated Hospital of Jining Medical University, Jining 272029, P.R.China.
J BUON. 2021 Sep-Oct;26(5):2053-2058.
This study aimed to investigate the computed tomography (CT) and magnetic resonance imaging (MRI) features of different histological types of renal cell carcinoma (RCC) (clear cell RCC (ccRCC), papillary RCC (pRCC), chromophobe RCC (chRCC).
The clinical data of 67 patients (including 38 patients with ccRCC, 20 patients with pRCC and 9 patients with chRCC) with RCC confirmed pathologically in the Affiliated Hospital of Jining Medical University were retrospectively analyzed. All patients underwent CT, MRI plain scan and three-phase enhanced scan, and their CT and MRI imaging features were analyzed.
Most of the enhancement was non-uniform. Most of the lesions presented as "fast-in, fast-out", with obvious enhancement in the early stage and enhancement decline in the later stage. Non-uniform and slightly higher signals were mostly present in DWI. The CT scan of pRCC patients showed equal density and homogeneous enhancement. Some of the larger lesions showed cystic necrosis and hemorrhage. MRI showed a lower signal on T1WI and a slightly higher signal on T2WI. The CT of patients with chRCC showed equal density and more uniform enhancement. DWI showed high signal, and central radial scar showed low signal. There was a significant difference in the percentage of cystic necrosis in ccRCC, pRCC and chRCC among groups (p<0.05). The incidence of cystic necrosis in ccRCC and pRCC was significantly higher than that in chRCC (p<0.05). The CT values in ccRCC patients were significantly higher than those in pRCC and chRCC patients in the parenchymal phase, corticomedullary phase and excretory phase (p<0.05). The CT value of chRCC patients in the parenchymal phase was significantly higher than that of pRCC (p<0.05).
The CT and MRI of ccRCC, pRCC and chRCC have their own imaging characteristics, which has important reference value for the preoperative differential diagnosis of RCC.
本研究旨在探讨不同组织学类型肾细胞癌（RCC）（透明细胞 RCC（ccRCC）、乳头状 RCC（pRCC）、嫌色细胞 RCC（chRCC）的计算机断层扫描（CT）和磁共振成像（MRI）特征。
回顾性分析济宁医学院附属医院经病理证实的 67 例 RCC 患者（包括 38 例 ccRCC 患者、20 例 pRCC 患者和 9 例 chRCC 患者）的临床资料。所有患者均行 CT、MRI 平扫及三期增强扫描，分析其 CT 和 MRI 影像学特征。
增强多不均匀，多数病灶呈“快进快出”表现，早期明显强化，后期强化减退。DWI 多呈不均匀稍高信号。pRCC 患者 CT 扫描呈等密度，均匀强化，部分较大病灶呈囊变坏死、出血。MRI 表现为 T1WI 低信号，T2WI 稍高信号。chRCC 患者 CT 表现为等密度，强化更均匀。DWI 呈高信号，中央放射状瘢痕呈低信号。ccRCC、pRCC 和 chRCC 三组间囊性坏死比例差异有统计学意义（p<0.05）。ccRCC 和 pRCC 囊性坏死发生率明显高于 chRCC（p<0.05）。ccRCC 患者实质期、皮髓质期、排泄期 CT 值明显高于 pRCC 和 chRCC 患者（p<0.05）。chRCC 患者实质期 CT 值明显高于 pRCC 患者（p<0.05）。
ccRCC、pRCC 和 chRCC 的 CT 和 MRI 具有各自的影像学特征，对 RCC 的术前鉴别诊断具有重要的参考价值。
