Objective To investigate the correlation between pathological features of clear cell renal cell carcinoma(ccRCC) and Fuhrman classification with enhanced MDCT image findings.Methods CT findings and clinical data of 108 ccRCC patients confirmed by pathology were collected and the CT values of tumor parenchyma,ipsilateral renal cortex and aorta were measured and absolute and relative CT values of tumor parenchyma were calculated.According to the Fuhrman pathological classification,all cases were divided into low grade (Fuhrman Ⅰ-Ⅱ) and high-grade (Fuhrman Ⅲ-Ⅳ) groups and the CT findings included CT attenuation of four phases and the absolute and relative enhancement values were compared respectively.Results Low-grade tumors differed from high-grade tumors with lower attenuation on unenhanced CT scan,absolute enhancement values in three phases were higher,relative enhancement values were also higher in arterial and venous phases,the difference were statistically significant (P＜0.05).A1 (r =-0.311,P＜0.05) and the absolute enhancement in delay(r =-0.310,P＜0.05) and nephrographic phase(r =-0.304,P＜0.05) were negatively correlated to the Fuhrman grade,A 1 (AUC =0.707),C1 (AUC =0.705) and corticomedullary phase absolute enhancement (AUC =0.675) had the more larger AUCs.Conclusion The MDCT enhancement index of ccRCC is negatively correlated with pathological Fuhrman grading which is helpful to predict the grade of ccRCC before operation and has certain clinical values.

Clinically,pancreatic cancer is a highly aggressive tumor,and neurotropic growth is an important biological feature of pancreatic cancer.Nerve invasion brings great pain burden to patients,and it seriously affects the quality of life and the will to survive of patients.The"three-step analgesia principle"for the management of cancer pain proposed by World Health Organization(WHO)is a traditional therapeutic regimen for cancer pain.However,because of its obvious toxic side effects,poor efficacy,easy addiction,easy drug resistance,non-standard medication of clinical physicians,etc.,the"three-step analgesia principle"is unable to meet the needs of the patient's condition..In recent years,with the development of interventional technology and the development of extensive clinical trials,the interventional means,which is regarded as the"fourth step"of cancer pain management,has achieved great clinical effect,it includes various therapeutic methods and imaging-guided techniques such as neural destruction(denervation),125I particle implantation,patient-controlled analgesic pump technology,implantation of intrathecal drug infusion system,etc.,and clinical practice has proved that these techniques have significant clinical efficacy and they can provide a convenient,safe and effective treatment method for HCC patients.