Comparing The Value Of Ultrasonic Imaging And CT In Diagnosis Of Cystic Renal Cell Carcinoma

Objective: To analyze the imaging features of cystic renal cell carcinoma (CRCC) with ultrasound and computer tomography(CT) and compare their values in clinical diagnosis.Materials and Methods: 31 patients with exact pathological result of CRCC were analyzed with preoperative-scanned ultrasonic and CT plain and contrasted imaging. The size of kidney, the location, number, size and mural thickness of the cytic lesions, the shape and size of mural nodule, the thickness of septum, as well as the imaging characteristics of nodule, septum and cystic mass were analyzed both in ultrasound and CT. Additionally, blood supply of CRCC were evaluated in ultrasonic doppler and in CT with three-phased contrasted imaging. Finally, the value of ultrasound and CT in the diagnosis of CRCC were estimated statistically, according to the pathological result.Results: Of 31 patients with CRCC, 12 patients with 13 lesions were unicystic and 19 patients 20 lesions were polycystic. There were mural nodule in 9 unicystic and 7 polycystic cases and there were septum in 10 unicystic and 13 polycystic cases on ultrasonic imaging, while there were mural nodule in 8 unicystic and 9 polycystic cases and there were septum in 8 unicystic and 13 polycystic cases detected by CT examination. With unicystic cases, simple cystic mass with fluid echoless or floating hypoecho, a bit thick wall or of variant thickness, intra-cystic septum as well as plentiful blood signal in mural nodule and septum was often detectd by ultrasonic device. When with polycystic cases, multilocular cystic mass with fluid echoless or floating hypoecho, clear demarcation, thin septum with one to several millimeters, expansion nodule or parenchymal mass adhering to mural wall or septum as well as poor colour signal in mural nodule and septum were showed in ultrasonic imaging. However, as detected by CT machine, simple cystic mass with mixed low densities(lower density in centre area and isodensity in peripheral area of the mass), indistinct scraps, spotted or plaque calcification and obviously enhanced septum, nodule, parenchyma and unenhanced cystic part were observed with unicystic cases. Moreover, multilocular cystic mass with liquid low density, septum with mixed density and the same post-enhancemental appearance as unicystic cases were demonstrated with polycystic cases. The positive predictive value of ultrasound was 64.52% and of CT was 58.06%. There was no significant difference between ultrasound and CT when making diagnosis of CRCC. The positive predictive value of combining ultrasound and CT was 90.32%, which is significantly higher than ultrasound or CT.Conclusion: There are some imaging features with CRCC in ultrasound and CT which will promisingly improved the diagnosis if they were well-catched. There is no significant difference between ultrasound and CT in the diagnosis of CRCC, thus, it is suggested the joint application of them may improve the sensitivity of disease diagnosis.