多排螺旋CT对乏脂肪肾血管平滑肌脂肪瘤的诊断价值
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摘要
目的分析多层螺旋CT对乏脂肪肾血管平滑肌瘤的诊断价值。方法对35例临床怀疑为乏脂肪肾血管平滑肌瘤的患者分别采用多层螺旋CT检查与病理组织标本活检;比较2种检测方法对乏脂肪肾血管平滑肌瘤的检出情况,分析乏脂肪肾血管平滑肌瘤多层螺旋CT的影像学特点与表现,评价多层螺旋CT对乏脂肪肾血管平滑肌瘤诊断的真实性。结果 35例患者病理确诊乏脂肪肾血管平滑肌瘤25例;多层螺旋CT诊断为乏脂肪肾血管平滑肌瘤21例,其中假阴性5例、假阳性1例。多层螺旋CT对乏脂肪肾血管平滑肌瘤诊断的灵敏度为80.0%,特异度为90.0%,阳性预测值为95.2%,阴性预测值为64.3%,正确指数为70.0%,ROC曲线下面积为0.850。结论多层螺旋CT对乏脂肪肾血管平滑肌瘤诊断的灵敏度较高,误诊率较低,具有较高的诊断价值。
Objective To analyze the value of multi-detector spiral CT for diagnosing minimal fat renal angiomyolipoma.Methods Thirty-five patients with suspected minimal fat renal angiomyolipoma underwent multi-detector spiral CT and tissue biopsy.The detection rates of the two methods were compared.CT characteristics and findings of minimal fat renal angiomyolipoma were analyzed to evaluate the authenticity of multi-detector spiral CT for diagnosing minimal fat renal angiomyolipoma.Results Among the 35 cases,minimal fat renal angiomyolipoma was confirmed by pathology in 25,and by multi-detector spiral CT in 21(5false negative cases and 1false positive case).The sensitivity,specificity,positive predictive value,negative predictive value,correct index and area under the ROC curve of multi-detector spiral CT for diagnosing minimal fat renal angiomyolipoma were 80.0%,90.0%,95.2%,64.3%,70.0% and 0.850,respectively.Conclusion Multi-detector spiral CT has higher sensitivity and value and lower misdiagnosis rate in the diagnosis of minimal fat renal angiomyolipoma.
Objective To analyze the value of multi-detector spiral CT for diagnosing minimal fat renal angiomyolipoma.Methods Thirty-five patients with suspected minimal fat renal angiomyolipoma underwent multi-detector spiral CT and tissue biopsy.The detection rates of the two methods were compared.CT characteristics and findings of minimal fat renal angiomyolipoma were analyzed to evaluate the authenticity of multi-detector spiral CT for diagnosing minimal fat renal angiomyolipoma.Results Among the 35 cases,minimal fat renal angiomyolipoma was confirmed by pathology in 25,and by multi-detector spiral CT in 21(5false negative cases and 1false positive case).The sensitivity,specificity,positive predictive value,negative predictive value,correct index and area under the ROC curve of multi-detector spiral CT for diagnosing minimal fat renal angiomyolipoma were 80.0%,90.0%,95.2%,64.3%,70.0% and 0.850,respectively.Conclusion Multi-detector spiral CT has higher sensitivity and value and lower misdiagnosis rate in the diagnosis of minimal fat renal angiomyolipoma.
引文
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[8]宁柳金,李光宇,彭汉华,等.16层螺旋CT三维重建成像技术在骨盆骨折中的临床意义[J].现代生物医学进展,2013,54(16):3108-3111,3194.
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[10]黄海东,刘洪,曹伟,等.乏脂肪肾血管平滑肌脂肪瘤的MSCT和MR化学位移成像表现及病理基础[J].CT理论与应用研究,2015,19(3):467-474.
[11]包迎伟,傅立平,纪建松,等.MSCT对肾血管平滑肌脂肪瘤的诊断价值[J].中国中西医结合肾病杂志,2010,75(12):1081-1083,1140.
[12]王宗勇,熊燕,陈志凡.乏脂肪肾血管平滑肌脂肪瘤的多层螺旋CT表现[J].肿瘤预防与治疗,2014,26(6):264-267.
[2]孟庆成,王立峰,贾丙鑫,等.乏脂肪肾血管平滑肌脂肪瘤与肾细胞癌的影像鉴别征象的应用价值评估[J].临床放射学杂志,2013,31(2):225-228.
[3]顾庆春,范亦辉,陈炜,等.肾透明细胞癌与乏脂性肾血管平滑肌脂肪瘤的CT鉴别诊断[J].临床放射学杂志,2012,45(9):1299-1301.
[4]Parashari U C,Khanduri S,Bhsdury S,et al.Multi-detector computed tomography angiography of a ruptured giant renal angiomyolipoma with pseudoaneurysm and associated saccular dilatation of left renal artery[J].Urol J,2013,10(4):1147-1150.
[5]肖宽祥.肾血管平滑肌脂肪瘤的CT诊断及鉴别诊断[J].中国医学创新,2012,12(33):91-92.
[6]Jhaveri K S,Elmi A,Hosseini N H,et al.Predictive value of chemical-shift MRI in distinguishing clear cell renal cell carcinoma from non-clear cell renal cell carcinoma and minimal-fat angiomyolipoma[J].AJR Am J Roentgenol,2015,205(1):79-86.
[7]丰琅,张道新,田野,等.乏脂性肾血管平滑肌脂肪瘤患者9例临床分析[J].现代泌尿外科杂志,2014,32(7):450-452.
[8]宁柳金,李光宇,彭汉华,等.16层螺旋CT三维重建成像技术在骨盆骨折中的临床意义[J].现代生物医学进展,2013,54(16):3108-3111,3194.
[9]王寿明,李豪胜.多排螺旋CT检查对乏脂肪肾血管平滑肌脂肪瘤的诊断价值[J].重庆医学,2015,102(21):2928-2930.
[10]黄海东,刘洪,曹伟,等.乏脂肪肾血管平滑肌脂肪瘤的MSCT和MR化学位移成像表现及病理基础[J].CT理论与应用研究,2015,19(3):467-474.
[11]包迎伟,傅立平,纪建松,等.MSCT对肾血管平滑肌脂肪瘤的诊断价值[J].中国中西医结合肾病杂志,2010,75(12):1081-1083,1140.
[12]王宗勇,熊燕,陈志凡.乏脂肪肾血管平滑肌脂肪瘤的多层螺旋CT表现[J].肿瘤预防与治疗,2014,26(6):264-267.