The Comparative Study Of Quantitative MSCT Enhancement Parameters And Perfusion Parameters With Pathology In Renal Cell Carcinoma

â… . The Study of Quantitative MSCT Enhancement Parameters and Enhancement Pattern for the Differentiation of the Subtypes of Renal Cell CarcinomaObjectiveThe purpose of our study was to evaluate quantitative CT enhancement parameters and enhancement pattern of multiphasic multislice spiral CT(MSCT) enhancement patterns to enable lesion of differentiation of the subtypes of renal cell carcinoma (RCC).Methods42 cases of RCC proved by surgery and pathology were performed with multiphasic MSCT scanning of unenhanced phase, corticomedullary phase(CMP), nephrographic phase(NP) and excretory phases(EP)before operation. We reviewed CT scans of three subtypes of renal cell carcinoma: 32 conventional (clear cell), 5 papillary RCC and 5 chromophobe RCC. We used a new method to standardize enhancement measurement in lesions on multiphasic CT not being influenced by intrinsic factors like cardiac output. The degree according to standardize enhancement measurement and pattern of enhancement were compared and analyzed.ResultsAccording to the result of new correction method,conventional renal cell carcinoma showed stronger enhancement than the other subtypes (P<0.05) in the corticomedullary phase.The peak time of CCRCC and PRCC were in corticomedullary phase,which was earlier than that of ChRCC. The cutoff value with the highest accuracy for the differentiation of conventional renal carcinoma from nonconventional renal carcinomas was 100 H in the corticomedullary phase.Most of CCRCC and PRCC tended to show heterogeneous or predominantly peripheral enhancement, whereas ChRCC usually showed homogeneous enhancement.ConclusionFor the differentiation of the subtypes of renal cell carcinoma, quantitative CT enhancement parameters is the most valuable parameter.The new correction method and enhancement pattern can serve important roles in the identification of the subtype of RCC. â…¡. The Correlation of MSCT Perfusion Parameters with Tumor Angiogenesis and Cell Multiplication in Renal Cell CarcinomaObjectiveTo investigate the correlation of MSCT perfusion parameters with tumor microvessel density (MVD),vascular endothelial growth factor (VEGF) and Ki-67 antigen in RCC.MethodsThe study included 26 cases of RCC proven histopathologically and 15 healthy volunteers as control. Target-slice dynamic enhanced scanning was performed by MSCT for all patients. Parameters including blood flow (BF),relative blood value (rBV),time to peak(TTP),permeability (Pm) and time-density curve (TDC) were analyzed using perfusion software. MVD,VEGF and Ki-67 antigen expression were measured with immuno-histology chemistry technique (SP technique) . The results were compared with MSCT perfusion imaging.Resultsâ‘ There were significant differences for BF,rBVand Pm between different tumor cell grades,RCC and normal renal cortex. There was no significant association for TTP between different tumor cell grades,RCC and normal renal cortex.â‘¡There were significant differences for MVD and Ki-67 antigen between different tumor cell grades.There was no significant association for VEGF between different tumor cell grades.â‘¢CT perfusion parameters,including BF,rBV and Pm had significant correlations with MVD and Ki-67 antigen of lesions. TTP had no correlation with MVD and Ki-67 antigen of lesions.There was no correlation between VEGF and perfusion parameters exclude BF.ConclusionBlood flow perfusion and permeability of RCC could be quantitatively measured by MSCT perfusion imaging. MSCT perfusion provides useful information for pre-surgical staging,which is a valuable means to assess tumor angiogenesis and cell multiplication,which is significant in the diagnosis and treatment of RCC.