The Diagnostic Value Of Early Enhancement Scanning With Dual-energy Dual-phase Ct For The Diagnosis And Dubtype Differentiation Of Renal Cellcarcinoma

Objective Evaluating the value of the diagnosis of Renal clear cell carcinoma in enhanced dual-energy CT scanning. This study was approved by our institutional review board and the informed consent requirement was waived. Pathologically confirmed 67 cases Renal carcinoma contains 54 cases Renal clear cell carcinoma 、 9 cases Papillary renal cell carcinoma、4 cases chromophobe renal cell carcinoma, underwent dual-energy biphase :early corticomedullary(after the administration of contrast agent 20s)and delayed phase scan(after the administration of contrast agent 90s) preoperatively between Jan.2014 and Dec. 2014. We get the images of virtual unenhanced and overlay by using the workstation software, The clearness degree was marked as 5 points in the 80 KV,140KV and 120 KV images: 1. Not visible 2. Doubtful visible 3.Not obvious, need to regulate the window width 4. Visible 5. Definitely visible. 2 or lower than 2 level mean no lesion was found and 3 or higher level mean the discovery of the lesion. All the images were evaluated in the 350 and 40 window width. We measured the iodine concentration of the lesion and the aorta in the early corticomedullary phase(ECM) and delayed phase(EP), calculate the normalized iodine concentration(NIC). Meanwhile, we compared the morphologic and enhancement features of high and low grade cc RCC)。Results There were 64 lesions(95.5%) found in the early corticomedullary phase while 67(100%) lesions found in the delayed phase,and there was difference between the two phases(c2=3.069,p=0.08). There are 54 cases Renal clear cell carcinoma,9cases Papillary renal cell carcinoma and 4 cases Chromophobe renal cell carcinoma. The value of NIC in ECM was higher in clear cell subtype than the non-clear cell subtype(P=0.000); There was no difference in the the value of NIC between ch RCC and p RCC.The value of NIC in EP were no difference during three subtypes of renal cell carcinoma. The value of NIC in EP were no difference between the high and low grate renal clear cell carcinoma.Conclusion 1. DECT could Diagnosis the renal carcinoma in the early corticomedullary phase,which was similar to the findings with single energy CT.2. We could differentiate the clear cell and non-clear cell renal cell carcinoma by the Iodine image in the early corticomedullary phase with DECT,can offer help for clinical treatment.