【摘要】 目的 探讨肾脏透明细胞癌(RCC)CT增强程度与微血管及成熟血管多种血管特征之间的关系。方法 选择在本院行平扫及三期增强CT扫描并经手术病理证实的RCC患者37例(37个病灶)进行回顾性分析，测量动脉期、静脉期和延迟期RCC的绝对增强值(增强CT值-同部位平扫CT值)和相对增强值(绝对增强值÷同期正常肾实质增强值),同时将病灶分为富血管和乏血管组。CD34和aSMA免疫组化染色分别测量微血管和成熟血管的数目、平均周长、面积及直径、形态指数、总面积等。对各CT测量参数与病理学指标之间的关系进行分析。结果 在动脉、静脉和延迟期，RCC成熟血管和微血管的数目及总面积均与其绝对强化值正相关(P<0.05),成熟血管及微血管的数目均与相对强化值正相关(P<0.05);在静脉和延迟期，成熟血管的平均面积、平均周长、平均直径则均与相对强化值负相关(P<0.05),而其余血管参数与绝对和相对强化值之间未见相关性(P>0.05)。在富血供和乏血管RCC之间，成熟血管和微血管的数目均具有统计学差异(P<0.05)。结论 RCC的绝对增强值和相对增强值与微血管和成熟血管的一些特定指标密切相关，利用CT增强参数可对这些病理学血管指标进行大致评估，同时也拓展了RCC复杂CT增强表现的理论基础。更多还原

【Abstract】 Objective To elucidate the correlation between the enhancement degree of renal clearcell carcinoma(RCC) on dynamic contrast-enhanced CT and multiple vascular morphometric characteristics including microvessels and mature vessels.Methods A retrospective review was carried out on the records of 37 patients pathologically diagnosed with RCC who underwent plain and triphasic contrast-enhanced CT.The absolute(enhancement attenuation—pre-enhancement attenuation) and relative(absolute enhancement value÷cortex enbancement attenuation) enhancement values of RCC were measured in arterial,venous and delayed phases.And all lesions were divided into hypervascular and hypovascular groups.The number,mean area,perimeter and diameter,shape factor(4π *area/peri meter~2) and the total area of microvessels and mature vessels were obtained by CD34 or a-SMA immunohistochemical staining.Then the correlation of radiographic parameters and various vascular morphometric parameters were analyzed.Results In arterial,venous and delayed phases,the absolute enhancement values were positively correlated with the number and the total area of microvessels and mature vessels(P<0.05),meanwhile the relative enhancement values were positively correlated with the number of microvessels and mature vessels(P <0.05).In venous and delayed phases,there were negative correlations of the relative enhancement values with mean area,perimeter and diameter of mature vessels(P<0.05).However,no correlations were found between other enhancement and vascular parameters(P>0.05).In addition,the significant differences in the number of microvessels and mature vessels between hypervascular and hypovascular groups were found(P<0.05).Conclusion CT enhancement degrees of RCC are related to multiple vascular morphometric indicators,which gives us more insights in the mechanism of RCC enhancement on CT.更多还原