摘要
目的：探讨肾癌螺旋CT动态增强扫描表现，提高诊断水平。方法：回顾性分析72例经手术病理证实的肾脏恶性肿瘤CT动态增强扫描资料，其中肾细胞癌57例，依据WHO病理分类包括透明细胞癌38例、乳头状癌10例、嫌色细胞癌8例、梭形细胞癌1例。比较平扫、皮髓质期、肾实质期及排泄期各型肾癌的强化程度及强化模式。结果：3种肾癌在平扫的CT值无统计学差异。在增强扫描皮髓质期、肾实质期及排泄期，透明细胞癌的CT值均高于乳头状癌和嫌色细胞癌（P值分别为0.01、0.01和0.03），而后二者在增强各期均无统计学差异。均匀强化最常见于嫌色细胞癌，不均匀强化最常见于透明细胞癌。结论：螺旋CT动态增强扫描鉴别透明细胞癌与非透明细胞癌有应用价值，同时在肾癌的鉴别诊断上具有重要意义，可用于在术前指导治疗方案的制定。
Abstract
Objective: To investigate the signs of renal cell carcinoma(RCC), and improve the imaging diagnosis of renal malignant neoplasm with multi-phase dynamic enhancement CT scanning. Materials and Methods: The multi-phase contrast enhanced helical CT scan data of 72 patients with surgical-pathologically proved renal malignant neoplasm were analyzed retrospectively. Fifty-seven cases of RCC, confirmed by pathological techniques, according to WHO classification, these included 38 clear cell carcinomas, 10 papillary, 8 chromophobe and 1 spindle cell RCC, were analyzed. Enhancement degrees and patterns in unenhanced, corticomedullary, nephrographic phase and excretory phase were compared. Results: CT attenuation on unenhanced scan was not statistically different. CT attenuation of clear cell carcinoma was higher than that of papillary and chromophobe RCC in corticomedullary, nephrographic and excretory phase(P value is 0.01, 0.01 and 0.03 respectively), while that of papillary and chromophobe RCC was not statistically different in all three phases. Homogeneous and heterogeneous enhancement was most commonly seen in chromophobe RCC and clear cell carcinoma. Conclusion: Dynamic enhanced CT scan was effective for differentiating clear cell carcinoma from non-clear cell carcinoma, and was useful in differentiating RCC. It could be used in formulating therapeutic plan preoperatively.
关键词
肾肿瘤 /
体层摄影术 /
螺旋计算机
Key words
Kidney neoplasms /
Tomography /
spiral computed
张祎年;周俊林;何 宁;毛俊杰;白亮彩;赵建洪;李晓鸣.
螺旋CT动态增强扫描在肾癌亚型诊断中的应用[J]. 中国临床医学影像杂志. 2009, 20(7): 523-526
ZHANG Yi-nian;ZHOU Jun-lin;HE Ning;MAO Jun-jie;BAI Liang-cai;ZHAO Jian-hong;LI Xiao-ming.
The application of dynamic enhanced spiral CT in the diagnosis of renal cell carcinoma[J]. Journal of China Clinic Medical Imaging. 2009, 20(7): 523-526
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