【摘要】：目的:探討磁共振各序列顯示腎細(xì)胞癌(RCC)假包膜的差異及假包膜在腫瘤剜除手術(shù)中的意義。方法:收集我院2012年10月~2014年1月46例腎臟非囊性腫瘤患者臨床資料,男27例,女19例,年齡25~76歲,平均47歲。腫瘤位于左側(cè)22例,右側(cè)24例。所有患者術(shù)前均行MRI檢查,觀察假包膜的MRI各序列表現(xiàn),并與病理對照,評價(jià)磁共振成像各序列顯示RCC假包膜的敏感性和特異性,并分析RCC組織學(xué)類型、分級及臨床分期對假包膜完整性的影響,數(shù)據(jù)分析采用卡方檢驗(yàn)。結(jié)果:T1WI、T2WI、T2抑脂、T1增強(qiáng)顯示RCC假包膜的敏感性分別為43.8%、87.5%、50.0%、43.8%,差異具有統(tǒng)計(jì)學(xué)意義(χ2=8.635,P=0.035);特異性分別為53.8%、80.8%、38.5%、46.2%,差異有統(tǒng)計(jì)學(xué)意義(χ2=10.676,P=0.014)。病理顯示腎透明細(xì)胞癌的假包膜完整率40.6%,乳頭狀腺癌假包膜完整率30.0%,兩者比較差異無統(tǒng)計(jì)學(xué)意義(χ2=0.53,P=0.817);高分化RCC包膜完整率達(dá)56.5%,中、低分化RCC假包膜完整率僅15.8%,差異有統(tǒng)計(jì)學(xué)意義(χ2=7.32,P=0.007);Ⅰ期、Ⅱ期、Ⅲ+Ⅳ期RCC的包膜完整率分別為61.1%、30.8%、9.0%,差異有統(tǒng)計(jì)學(xué)意義(χ2=9.013,P=0.011)。結(jié)論:RCC假包膜在MRI的常規(guī)T2加權(quán)像上顯示最為敏感,若術(shù)前MRI顯示腫瘤周圍存在完整假包膜,預(yù)示著腫瘤分化較好,臨床分期較低,已經(jīng)發(fā)生癌細(xì)胞局部擴(kuò)散及遠(yuǎn)處轉(zhuǎn)移的可能性較小,提示腫瘤剜除術(shù)的可行性。
[Abstract]:Objective: to investigate the difference of (RCC) pseudocapsule in different MRI sequences and the significance of pseudocapsule in tumor enucleation. Methods: the clinical data of 46 patients with renal non-cystic tumor from October 2012 to January 2014 were collected. There were 27 males and 19 females, aged 2576 years with an average of 47 years. The tumor was located on the left in 22 cases and on the right in 24 cases. All patients were examined with MRI before operation. The MRI sequences of pseudocapsule were observed and compared with pathology. The sensitivity and specificity of RCC pseudocapsule were evaluated and the histological types of RCC were analyzed. The effect of grade and clinical stage on the integrity of false capsule was analyzed by chi-square test. Results: the sensitivity of T _ 1WI ~ T _ 2WI T _ 2 and T _ 1 enhancement in displaying RCC pseudocapsule were 43.8% and 87.5%, respectively. The difference was statistically significant (蠂 ~ 2 ~ (8.635) P ~ (0.035). The specificity was 53.8% and 80.8%, 38.5% and 46.2%, respectively. The difference was statistically significant (蠂 ~ 2 = 10.676). The rate of pseudocapsule integrity was 40.6 in renal clear cell carcinoma and 30.0 in papillary adenocarcinoma. There was no significant difference between the two groups (蠂 ~ 2 ~ (2) 0.53). The complete rate of well-differentiated RCC capsule was 56.5%, while that of poorly differentiated RCC was only 15.8.The difference was statistically significant (蠂 ~ 2 + 7.32% P ~ (0.007). The complete rate of RCC in stage 鈪，

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