Application Value Of Energy Spectral CT Multi-Parameter In Typing And Staging And Nuclear Grade Of Renal Cell Carcinoma

Objective: To explore the value of multi-parameters of energy spectrum CT in the typing,staging and nuclear grading of renal cell carcinoma,and to improve the accurate evaluation of renal cell carcinoma using Energy spectrum CT before surgey before surgery,and provide evidence for clinical treatment and prognosis.Methods: From 2014 to 2019,the imaging and pathological data of renal cell carcinoma were analyzed.Energy spectrum CT scan was performed before operation,and the spectral CT parameters of all cases were recorded blindly.All tumors were surgically removed.All tumors were surgically removed,and the specimens were excised for HE staining and immunohistochemical staining.After the operation,the imaging data and pathological data were compared and analyzed.The data were statistically analyzed using Spss 23.0 statistical software.Results: 1.type: The 70 Kev single-energy CT value of renal cell carcinoma with different types in the cortical phase was statistically significant(F=68.810,P<0.001),the 70 Kev single-energy CT values of each subtype of renal cell carcinoma were statistically significant(F=16.196,P=0.034;F=13.326,P<0.001;F=18.376,P=0.007).There was a statistically significant difference in NIC values between different types of renal cell carcinoma in the cortical phase(F=92.699,P=0.008),there are differences in NIC for every two different renal cell carcinomas(F=7.318,P=0.007;F=3.338,P<0.001;F=7.406,P=0.04);There was a statistically significant difference in K value between different types of renal cell carcinoma in the cortical phase(F=48.712,P<0.001),there are differences in NIC for every two different renal cell carcinomas(F=7.406,P=0.035;F=16.745,P=0.001;F=25.558,P<0.027).2.Grade: In the cortical phase,the 70 Kev single-energy CT value,NIC,and K values of high-grade and low-grade clear cell carcinoma were statistically significant(F=30.157,P=0.001;F=10.434,P=0.003;F= 40.160,P < 0.001);in the parenchymal phase,there was a statistically significant difference in NIC and K between high-grade and low-grade clear cell carcinoma(P=0.045,P=0.029).3.Stage: There was no significant difference in the K value of the metastatic lymph nodes and the surrounding invasive fat of renal cell carcinoma with different stages of cortical and parenchymal phase.Conclusion: spectral CT parameters was used to make accurate diagnosis of renal cell carcinoma in terms of stage,type and nuclear grade,aiming at providing more accurate imaging evaluation before clinical surgery and providing more reliable basis for appropriate treatment scheme and accurate prognosis judgment.