Imaging performance and differences of type Ⅰ and type Ⅱ papillary renal cell carcinoma / 复旦学报（医学版）

ABSTRACT

Objective To identify the imaging performance and differences between type] and type Ⅱ papillary renal cell carcinoma (PRCC).Methods Data of 21 lesions of type Ⅰ,27 lesions of type Ⅱ (1 patient had 2 lesions) in 47 patients was retrospectively analyxed.All patients with pathologically proven PRCC were examined by contrast CT or MRI preoperatively.The morphological features,outside invasion signs and performance on contrast-enhanced CT were compared by qualitative and quantitative studies.The maximum diameter of tumors and CT values,△CT values in corticomedullary and nephrographic phase were analyzed by two-sample t-test,classified variable were compared by the Pearson X2 test or the Fisher exact test.Results On morphological behaviors,type Ⅱ PRCC were significantly larger than type Ⅰ PRCC (t =-2.604,P =0.013),more heterogeneous (X2 =14.928,P =0.000),greater probability to show cystic degeneration or necrosis (X2 =5.598,P =0.018) with more severity (X2 =4.769,P =0.029).There was no significant difference in hemorrhage and calcification between the two types observed by contrast-enhanced CT.Respectively,66.7 ％ of type Ⅱ PRCC and 23.8％ of type Ⅰ PRCC had papillary nodule,with obviously significant difference (X2 =8.694,P =0.003).In outside invasion signs,except for margins,type Ⅱ had more easily invaded peripheral fat,renal sinus and distant metastasis compared with type Ⅰ (P＜0.05).On contrast enhanced CT,there were significant differences in CT values and △CT values in corticomedullary phase between the two types (t =-2.674,P =0.012;t =-3.109,P =0.005).And there were no significant difference in unenhanced and nephrographic phase.Conclusions There were certain difference in morphological features,outside invasion signs and enhancement degree between type Ⅰ and type Ⅱ PRCC,and part of type Ⅱ PRCC had aggressive biological behaviors with worse prognosis.