Clear cell renal cell carcinoma:study on correlations between enhanced MDCT findings and Fuhrman grade / 实用放射学杂志

ABSTRACT

Objective To investigate the correlation between pathological features of clear cell renal cell carcinoma(ccRCC) and Fuhrman classification with enhanced MDCT image findings.Methods CT findings and clinical data of 108 ccRCC patients confirmed by pathology were collected and the CT values of tumor parenchyma,ipsilateral renal cortex and aorta were measured and absolute and relative CT values of tumor parenchyma were calculated.According to the Fuhrman pathological classification,all cases were divided into low grade (Fuhrman Ⅰ-Ⅱ) and high-grade (Fuhrman Ⅲ-Ⅳ) groups and the CT findings included CT attenuation of four phases and the absolute and relative enhancement values were compared respectively.Results Low-grade tumors differed from high-grade tumors with lower attenuation on unenhanced CT scan,absolute enhancement values in three phases were higher,relative enhancement values were also higher in arterial and venous phases,the difference were statistically significant (P＜0.05).A1 (r =-0.311,P＜0.05) and the absolute enhancement in delay(r =-0.310,P＜0.05) and nephrographic phase(r =-0.304,P＜0.05) were negatively correlated to the Fuhrman grade,A 1 (AUC =0.707),C1 (AUC =0.705) and corticomedullary phase absolute enhancement (AUC =0.675) had the more larger AUCs.Conclusion The MDCT enhancement index of ccRCC is negatively correlated with pathological Fuhrman grading which is helpful to predict the grade of ccRCC before operation and has certain clinical values.