Study on Clinical Application of Dual-source CT for Differentiating Diagnosis between Renal Clear Cell Carcinoma and Non-clear Cell Carcinoma

LU Yan-yan; CHEN Hong-wei; BAO Jian; FANG Xiang-ming; ZOU Xin-nong; TANG Qun-feng

doi:10.15953/j.1004-4140.2018.27.01.03

Abstract：Objective: To investigate the application of dual-source CT dual energy imaging technique in differential diagnosis of renal clear cell carcinoma and non-clear cell carcinoma. Methods: 68 cases of patients with suspected renal occupying lesions who received ultrasound, CT scan in our hospital from April 2015 to March 2017 were selected, all patients underwent dual-source CT scan. Comparative analysis of dual-source CT imaging features of renal clear cell carcinoma and non-clear cell carcinoma was taken, iodine concentration and NIC (normalized iodine concentration) of renal clear cell carcinoma and non clear cell carcinoma in corticomedullary phase and parenchyma phase , iodine concentration in different pathological grading and NIC of renal clear cell carcinoma were compared, sensitivity and specificity of differential diagnosis of dual source CT dual energy imaging technique used in diagnosing renal cell carcinoma and non clear cell carcinoma. Results: 32 cases who were confirmed by surgery and pathology had renal clear cell carcinoma and 17 cases had non clear cell carcinoma, after scanning of dual source CT dual energy imaging technique, the iodine concentration and NIC of patients with clear cell carcinoma in corticomedullary phase and parenchymal phase were higher than those of patients with non clear cell carcinoma, there was significant distance (P < 0.05); Iodine concentration and NIC of low grade (grade Ⅰ and Ⅱ) renal clear cell carcinoma patients in corticomedullary phase and parenchyma phase were significantly higher than those of the high grade (grade Ⅲ and Ⅳ), there was significant difference between the two groups (P < 0.05). In addition, analysis of diagnostic sensitivity and specificity of dual source CT dual energy imaging technique used in diagnosing renal cell carcinoma and non clear cell carcinoma showed: when NIC value of 0.704 was set as a standard in parenchyma phase, the differential diagnostic sensitivity (84.6％) and specificity (76.7％) of renal clear cell carcinoma and non clear cell carcinoma were the highest. Conclusion: Dual source CT dual energy imaging technique can distinguish renal cell carcinoma and non clear cell carcinoma via iodine quantitative analysis technique, it has higher zero sensitivity and specificity, can provide basis for pathologic grading of renal clear cell carcinoma.