摘要
目的：探讨CT尿路造影（CTU）对肾癌常见病理亚型的鉴别诊断价值。方法：回顾性分析经病理证实的150例肾癌患者5种病理亚型的CTU扫描各期横断及三维重建特征性表现，并比较各期各类肾癌的CT值。结果：透明细胞癌109例，多不均匀低密度而富血供；乳头状癌21例，多不均匀略高密度而少血供；嫌色细胞癌8例，多均匀略低密度而少血供；未归类癌9例，与透明细胞癌相似；多房囊性癌3例，呈多房囊性肿块。CT值比较：平扫乳头状癌高于透明细胞癌、嫌色细胞癌及未归类癌（P＜0.05），后3者无差异（P＞0.05）且4者明显高于多房囊性癌（P＜0.05）；皮髓质及肾实质期，透明细胞癌与未归类癌无差异（P＞0.05），但2者高于乳头状癌及嫌色细胞癌，而后2者无差异（P＞0.05）且4者明显高于多房囊性癌（P＜0.05）；排泄期，前4者无差异（P＞0.05），但均高于多房囊性癌（P＜0.05）。结论：肾癌常见病理亚型的CTU表现各具特征，具有鉴别诊断价值。
Abstract
Objective: To investigate the differential diagnostic value of common subtypes of renal cell carcinoma using CT urography(CTU). Methods: The images of CTU including characteristic manifestations of plain scanning and three-dimensional reconstruction in 150 cases of renal cell carcinoma proved by pathology were analyzed retrospectively and the CT value of different renal cell carcinoma in each period were compared. Results: There were 109 cases of clear cell renal cell carcinoma, 21 cases of papillary renal cell carcinoma, 8 cases chromophobe renal cell carcinoma, 9 cases of unclassified renal cell carcinoma and 3 cases of multilocular renal cell carcinoma. The above subtypes of renal cell carcinoma demonstrated characteristic features. Clear cell renal cell carcinoma exhibited inhomogeneous low density and hypervascular. Papillary renal cell carcinoma exhibited inhomogeneous high density and hypovascular. Chromophobe renal cell carcinoma was relatively homogeneous low density and hypovascular. Unclassified renal cell carcinoma is similar to clear cell renal cell carcinoma. Multilocular renal cell carcinoma presented as a multilocular cystic mass lacking an expansile nodule. The CT value of papillary is higher than clear cell renal cell carcinoma, chromophobe renal cell carcinoma and unclassified renal cell carcinoma(P<0.05) on plain scanning. The CT value of the latter three is indistinctive and the CT value of the above four subtypes is higher than multilocular renal cell carcinoma. There is no difference of clear cell renal cell carcinoma and uncalssified renal cell carcionma in CT value in arterial phase and venous phase(P>0.05), but CT value of them is higher than papillary renal cell carcinoma and chromophobe of which are indistinctive(P>0.05). The CT value of multilocular renal cell carcinoma is lower than the others(P<0.05) in arterial phase and venous phase. The CT value of multilocular renal cell carcinoma is lower than the others(P<0.05) of which are indistinctive(P>0.05) in delayed phase. Conclusion: Common subtypes of renal cell carcinoma demonstrated characteristic features in CTU and it is helpful for differentiation.
关键词
肾肿瘤 /
尿路造影术 /
体层摄影术 /
X线计算机
Key words
Kidney neoplasms /
Urography /
Tomography /
X-ray computed
牛玉军;王志铭;陈荣霞.
CT尿路造影对肾癌病理亚型的鉴别诊断价值[J]. 中国临床医学影像杂志. 2009, 20(6): 455-460
NIU Yu-jun;WANG Zhi-ming;CHEN Rong-xia.
Diagnostic value of CT urography in subtypes of renal cell carcinoma[J]. Journal of China Clinic Medical Imaging. 2009, 20(6): 455-460
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