Analysis of CT, MRI imaging features of renal cell carcinoma with different histopathological types.

Purpose: This study aimed to investigate the computed tomography (CT) and magnetic resonance imaging (MRI) features of different histological types of renal cell carcinoma (RCC) (clear cell RCC (ccRCC), papillary RCC (pRCC), chromophobe RCC (chRCC).

Methods: The clinical data of 67 patients (including 38 patients with ccRCC, 20 patients with pRCC and 9 patients with chRCC) with RCC confirmed pathologically in the Affiliated Hospital of Jining Medical University were retrospectively analyzed. All patients underwent CT, MRI plain scan and three-phase enhanced scan, and their CT and MRI imaging features were analyzed.

Results: Most of the enhancement was non-uniform. Most of the lesions presented as "fast-in, fast-out", with obvious enhancement in the early stage and enhancement decline in the later stage. Non-uniform and slightly higher signals were mostly present in DWI. The CT scan of pRCC patients showed equal density and homogeneous enhancement. Some of the larger lesions showed cystic necrosis and hemorrhage. MRI showed a lower signal on T1WI and a slightly higher signal on T2WI. The CT of patients with chRCC showed equal density and more uniform enhancement. DWI showed high signal, and central radial scar showed low signal. There was a significant difference in the percentage of cystic necrosis in ccRCC, pRCC and chRCC among groups (p<0.05). The incidence of cystic necrosis in ccRCC and pRCC was significantly higher than that in chRCC (p<0.05). The CT values in ccRCC patients were significantly higher than those in pRCC and chRCC patients in the parenchymal phase, corticomedullary phase and excretory phase (p<0.05). The CT value of chRCC patients in the parenchymal phase was significantly higher than that of pRCC (p<0.05).

Conclusion: The CT and MRI of ccRCC, pRCC and chRCC have their own imaging characteristics, which has important reference value for the preoperative differential diagnosis of RCC.