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開催概要
開催回
第56回・2018年・横浜
 

多相造影CTにおける腎細胞癌造影効果の定量化

演題番号 : P34-3

[筆頭演者]
演者)佐藤 元孝:1 
[共同演者]
藤本 幸太:1、木枕 舞:1、上戸 賢:1、中山 治郎:1、三宅 修:1

1:市立豊中病院・泌尿器科

 

Objectives: Contrast-enhanced computed tomography (CECT) is widely used for investigating renal tumors even if its ability to distinguish different subtypes has not yet been established. In the present study, we retrospectively analyzed and quantificated the enhancement characteristics of different subtypes of renal cell carcinomas (RCCs) on multiphasic CECT.
Methods: Patients who had surgical resection for renal tumors in the period February 2015 - June 2017 and who had pathologically proven RCC and who had multiphasic CECT (i.e., unenhanced phase (UP), corticomedullary pahse (CP), nephrographic pahse (NP), delay phase (DP)) at diagnosis were included. Mass enhancement value on CT images was measured by dragging a cursor over the entirely of the tumor in axial image demonstrating the largest diameter for each phase at same site. Maximum attenuation value in Hounsfield units (HU) of each lesion was calculated in 4-phases and attenuation characteristics were compared with the maximum attenuation of Aorta in CP. The patterns of each lesion were correlated with the histological subtypes.
Results: 39 clear cell RCCs (ccRCCs), 5 chromophobe RCCs (chRCC), 5 papiilary RCCs (pRCCs) and several removed metastatic focuses were reviewed. Attenuation value of ccRCC was significantly higher than chRCC in CP NP and DP (p<0.05), and higher than pRCC in CP (p<0.05). Attenuation characteristics of pRCCs demonstrated a distinct enhancement pattern than other RCCs. Significant differences were found between pRCCs and other RCCs with regard to enhancement ratio in UP/CP, CP/NP and DP/CP (p<0.05). Attenuation characteristics of Metastatic focus had similar tendency with its primary lesion.
Conclusions: In the series of patients, the angiodynamic behavior on multiphase CECT demonstrated distinct enhancement patterns; this differentiation could be useful in clinical management of RCCs.

キーワード

臓器別:腎・尿路・膀胱

手法別:診断

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