摘要
Abstract
Objective To investigate the value of combining contrast-enhanced ultrasound(CEUS)features with quantitative parameters from spectral CT in predicting the World Health Organization/International Society of Urological Pathology(WHO/ISUP)grading of clear cell renal cell carcinoma(ccRCC).Methods A retrospective analysis was conducted on 115 patients with pathologically confirmed ccRCC who underwent surgery at the First Hospital of Shanxi Medical University from June 2019 to September 2024.Based on WHO/ISUP grading,patients were classified into a low-grade group(grades 1-2,n=79)and a high-grade group(grades 3-4,n=36).All patients underwent preoperative CEUS and spectral CT examinations.Univariate analysis was used to compare CEUS features and spectral CT quantitative parameters between groups.Statistically significant parameters were selected to construct logistic regression models.The predictive performance of each model was assessed by calculating the area under the ROC curve(AUC).Results Univariate analysis revealed that several CEUS features,including contrast agent perfusion pattern,enhancement homogeneity,perilesional rim-like hyperenhancement,lesion boundary clarity,lesion morphology,and lesion extent before and after enhancement,these were significantly different between the two groups(P<0.05).Spectral CT parameters showing significant differences included lesion maximum diameter,corticomedullary phase CT value,iodine concentration,and normalized iodine concentration(P<0.05).Multivariate logistic regression analysis demonstrated that the CEUS model and the spectral CT model achieved sensitivities of 0.639 and 0.889,specificities of 0.848 and 0.785,accuracies of 0.774 and 0.809,and AUCs of 0.797 and 0.874,respectively.The combined model achieved superior diagnostic performance,with a sensitivity of 0.917,specificity of 0.810,accuracy of 0.852,and an AUC of 0.893.Conclusion The combination of CEUS features and spectral CT quantitative parameters provides a more accurate prediction of WHO/ISUP grading in ccRCC,offering valuable support for precision treatment in clinical practice.关键词
肾透明细胞癌/世界卫生组织/国际泌尿病理协会分级/超声造影/能谱CTKey words
clear cell renal cell carcinoma/World Health Organization/International Society of Urological Pathology grading/contrast-enhanced ultrasonography/spectral CT
