Gemstone CT Spectral Imaging Findings And Clinical Pathological Study For Fuhrman Grade Classification In Clear Cell Renal Carcinoma And Differential Diagnosis With Renal Angiomyolipoma

Objective: After doing gemstone CT spectral imaging on clear cell renal carcinoma and renal angiomyolipoma, the data of post-processing analysis should be contrasted with clinical pathological data, which is to explore the value of gemstone CT spectral imaging for malignancy grade classification of CCRCC and differential diagnosis with renal angiomyolipoma.Materials and methods: Collecting44patients with CCRCC and27cases of RAML between October2012and January2014, all cases were proved by surgery or biopsy pathology.All the patients underwent two phases of enhanced spectral CT imaging scanning and finished image reconstruction. On the spectrum image of arterial and venous phase,we can obtain CT values of renal lesions and abdominal aorta under different keV energy spectrum image, which is to calculate the CT value ratio between the lesions and abdominal aorta (standard CT value); By using spectrum analysis function of single energy images, we can obtain iodine-base figure and water-based figure of iodine and water as the base material and fat-base figure and water-based figure of fat and water as the base material,and measure iodine content, water content and fat content of lesions and abdominal aorta, which is to calculate the ratio between the lesions and abdominal aorta.And the obtained data received by the statistical analysis.Results:1. Each grade classification of the CCRCC in age, sex, location had no statistically significant,P>0.05.2. The malignancy grade classification of CCRCC in the presence of varicose vein bolt were statistically difference,P <0.05.(contrast each other):grade2and grade3,grade2and grade4of the lesion in the presence of varicose vein bolt were statistically difference,the percentage of grade2of the lesion in the presence of varicose vein bolt is lower than that of grade3and grade4of the lesion.3. CCRCC at all grades in the40-100keV single energy average value of arterial phase were statistically difference,P <0.05.The average value under the110-140keV have no statistical difference,P>0.05.4.CCRCC at all grades in the40-140keV single energy average value of venous phase have no statistical difference,P>0.05.5. RAML and CCRCC in the different locations have no statistical difference, P>0.05.6. The standard iodine content of arterial phase and the standard fat content of arterial phase in different grade classification of CCRCC were statistically difference, P<0.05.7. The standard iodine content of arterial phase, standard iodine content of venous phase, water content of arterial phase, standard fat content of arterial phase, standard fat content of venous phase in CCRCC and RAML were statistically difference, P<0.05. All the indicators of concentration of the CCRCC are higher than that of RAML.Conclusion:GSI has a certain value in differential diagnosis between CCRCC and RAML and malignancy grade classification of CCRCC. The percentage of grade2of CCRCC in the presence of varicose vein bolt is significantly lower than that of grade3and grade4of the lesion; At40-100keV, single energy average value of arterial phase, the standard iodine content of arterial phase and the standard fat content of arterial phase can distinguish different classification of CCRCC. The standard iodine content of arterial phase, standard iodine content of venous phase, water content of arterial phase, standard fat content of arterial phase, standard fat content of venous phase in CCRCC and RAML were statistically difference.