Differentiation of Renal Oncocytoma and Renal Cell Clear Carcinoma Based on Enhancement Pattern of MDCT
Objective To evaluate the diagnostic value of enhancement patterns and parameters for distinguishing renal oncocytoma(RO)from renal clear cell carcinoma(ccRCC)using Multidetector Computed Tomography(MDCT).Methods Clinical and imaging data of 30 cases of RO(31 lesions in total)and 47 cases of ccRCC confirmed by surgical pathology were retrospectively collected.The CT features,enhancement patterns and enhancement parameters were analyzed for both groups,including the mean peak enhancement of lesions in the three phases of enhancement,the lesion-to-cortical relative enhancement ratio(L/C),and the Peak Early Enhancement Ratio(PEER)of the tumors.The differential diagnostic value was evaluated by ROC analysis.Results RO lesions had distinct boundaries and central scarring was common,while ccRCC was more prone to cystic necrosis(P＜0.05);There was no statistically significant distinction in tumor growth pattern,calcification,and hemorrhage between the two groups.ccRCC group had an early contouring pattern of enhancement in 45 cases(95.7％),and the RO group had a persistent pattern of enhancement in 21 cases(64.5％);The mean peak enhancement of the lesions in both the RO and ccRCC groups appeared during the corticomedullary phase;However,ccRCC had significantly higher mean peak enhancements and L/C during the corticomedullary phase as well as PEER values compared to RO(P＜0.001).The diagnosis of RO using the cutoff values of cortical phase L/C＜1.01 and PEER＜0.995 had high accuracy and specificity.Conclusion Tumor enhancement pattern,enhancement parameters,central scarring,cystic necrosis,and clarity of the tumor boundary help distinguish RO from ccRCC.
万方数据
维普
