| Objective:To evaluate the therapeutic effect of everolimus on tissue components of renal angiomyolipoma associated with tuberous sclerosis,identify the main component types that reduce the volume of RAML tumor when everolimus is used to treat TSC-RAML,and determine whether the average density of TSC-RAML at the beginning of treatment can be an important predictor of the treatment of TSC-RAML with everolimus.Methods:From September 2017 to September 2022,all patients with TSC-RAML who met the diagnostic criteria of ITSCCC in the Department of Urology of Xijing Hospital of the Air Force Military Medical University were selected.A total of 47patients were finally included in our experimental study.According to the attenuation range of CT tissue specific threshold,the patients were divided into two groups:fat rich group:HU≤-10(n=26);Fat deficient group:HU≥30(n=21).All enrolled patients were treated with a standard dose of 10mg/d,and abdominal CT examinations were performed at baseline and at 6 months of follow-up.In the imaging department of our hospital,the CT data of the enrolled patients at baseline and after 6 months of treatment with everolimus were retrieved,and the relevant data were received and saved in DICOM format.The average HU values of the patients at baseline and after 6 months of treatment with everolimus were recorded respectively.3D reconstruction of RAML is carried out with the help of Mimics software,and the volume of RAML generated by the software is recorded.Observations:1.Observe and compare the difference of all characteristics and clinical manifestations of the two groups at baseline.2.Compare the volume change of RAML and the volume reduction rate of RAML between the two groups before and after treatment.3.Compare the difference of the average CT value transformation of RAML between the two groups before and after treatment,and analyze the reduction rate of CT value of the two groups before and after treatment.Results:There was no difference in sex,age,BMI,tumor location,baseline volume,number of tumors with baseline volume>100 cm~3and clinical features of TSC between fat rich group and fat deficient group(P>0.05);The median volume reduction in all patients after treatment was 11.72(3.12～27.23)cm~3,and the median reduction rate of tumor volume between two groups before and after treatment was 4.94(3.12～27.23)cm~3and 27.31(10.83～40.38)cm~3(P<0.05)respectively,and the reduction rate of tumor volume before and after treatment was 11.52±0.96%and 62.09±12.60%(P<0.05)respectively;The difference in CT values of all patients after treatment was 8.83±6.11HU,and the mean difference between the average CT values of the two groups before and after treatment was 4.23±3.01HU and 14.52±3.61HU respectively(P<0.05),and the reduction rate of CT values before and after treatment was 14.25±11.94%and 29.23±0.53%(P<0.05).In addition,some high-density corded vascular components in RAML decreased or even disappeared with the treatment of everolimus,instead of increasing low-density adipose tissue.Conclusion:Compared with the fat rich group,the effect of everolimus on reducing the tumor volume and the average CT value of the tumor in the fat deficient group is better and more significant,and there is a significant decrease in the vascular components of everolimus in both groups of patients.We believe that the reduction of everolimus is the high-density components of TSC-RAML,mainly vascular components.We speculate that the average density of TSC-RAML at the beginning of treatment can be used as an important predictor of the treatment of TSC-RAML with everolimus... |
PDF Full Text Request