摘要
目的：探讨肾集合管癌动态增强CT表现及其病理基础，增加对本病的认识，提高诊断准确性。方法：经手术病理证实的肾集合管癌7例，术前分别行CT平扫及双期（皮髓交界期及实质期）增强扫描。结果：7例肾集合管癌均以肾脏髓质为中心；所有病灶境界不清，与周围正常肾实质呈犬齿交错状排列，未见包膜；7例肿瘤中，1例肿瘤密度均匀，4例肿瘤密度不均匀，1例肿瘤呈显著低密度；平扫肿瘤实质成分CT值平均为35.5HU（30.1～44.7HU），动态增强后肿瘤呈进行性延迟强化，皮髓交界期CT值平均为52.7HU（34.2～72.0HU），实质期CT值平均为74.5HU（40.0～89.3HU）。病理上肿瘤有明显的间质反应，伴纤维增生，而纤维间质多呈延迟强化。结论：肾集合管癌中心多位于肾髓质，肿瘤境界不清，无包膜，患肾轮廓相对正常；肿瘤密度多样，增强扫描呈轻中度进行性延迟强化。集合管癌具有不同于其他肾细胞癌的CT特点，影像表现与病理密切相关。
Abstract
Objective: To investigate the relationship between dynamic enhanced MDCT and histopathologic findings of the collecting duct carcinoma(CDC), in order to improve diagnostic accuracy. Methods: Seven cases with pathologically proven CDC of the kidney underwent spiral CT plain scan, post-contrast cortico-medullary phase and nephrographic phase scans before surgery. Results: All of the 7 tumors presented normal renal contour with tumor located in renal medullary. All tumors manifested an infiltrative growth pattern and were ill-defined, and displayed an interlocking arrangement with the surrounding normal renal parenchyma, no capsule was found. The tumor density was correlated with the composition of tumor in pathology. The CT value of the solid component on plain scan images was 30.1～44.7HU(mean=35.5HU), after contrast enhancement, the CT value of tumor on cortico-medullary phase images and nephrographic phase images was 34.2～72.0HU(mean=52.7HU) and 40.0～89.3HU(mean=74.5HU) respectively. Progressive delayed enhancement after contrast enhancement was related to pathologically apparent stromal reaction and fibrosis, while the fibrous stroma often manifested a delayed enhancement. Conclusion: The CT characteristics of CDC were different from the other renal cell carcinoma and the image findings are closely related to pathology.
关键词
肾肿瘤 /
体层摄影术 /
螺旋计算机
Key words
Kidney neoplasms /
Tomography /
spiral computed
刘学玲;周建军;曾蒙苏;丁 莺;纪 元;严福华;周康荣.
肾集合管癌的MDCT动态增强表现及其病理基础[J]. 中国临床医学影像杂志. 2011, 22(12): 860-863
LIU Xue-ling;ZHOU Jian-jun;ZENG Meng-su;DING Ying;JI Yuan;YAN Fu-hua;ZHOU Kang-rong.
Carcinoma of renal collecting duct: correlation with characteristics of dynamic enhanced MDCT and pathological basis[J]. Journal of China Clinic Medical Imaging. 2011, 22(12): 860-863
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