摘要
目的：探讨分次团注双期CT增强扫描在肾透明细胞癌中的临床应用价值。方法：选择我院B超或体检中怀疑肾脏占位患者120例，采用随机数字表法按照病例进行检查的先后顺序随机分成两组：实验组（60例）行肾脏分次团注双期CT增强扫描，对照组（60例）行常规三期增强扫描。术后对照病理结果，选择肾脏透明细胞癌患者共90例作为研究对象，实验组44例，对照组46例（120例患者中肾脏透明细胞癌患者共90例，选择这90例患者为研究对象，其中来自实验组的44例，来自对照组46例）。对（最终纳入的90例肾脏透明细胞癌）患者CT扫描各期病变及健肾实质强化程度进行对比分析；计算两组患者所受有效辐射剂量。结果：①实验组肾透明细胞癌皮质期、实质-排泄期与对照组皮质期、排泄期平均CT值之间无统计学意义（P=0.064，P=0.105）；实验组肾透明细胞癌实质-排泄期与对照组实质期平均CT之间具有统计学意义（P=0.000）；②实验组健肾实质皮质期与对照组皮质期平均CT值之间无统计学意义（P=0.510）；实验组健肾实质-排泄期与对照组实质期及排泄期强化平均CT值之间具有统计学差异（P=0.000，P=0.001）。③实验组的平均有效剂量较对照组减低30%。结论：肾脏分次团注双期增强扫描在定性诊断肾脏占位性病变的同时明显降低患者检查所受有效辐射剂量，具有重要临床应用价值。
Abstract
Objective: To explore the clinical value of split bolus multidetector computed tomographic(MDCT) enhanced examination in clear cell renal carcinomas(ccRCC). Methods: 120 patients suspected of kidney tumor by ultrasound or physical examination were divided into two groups randomly. The experimental group contained 60 cases who were given split bolus two phase CT enhanced scanning, the control group also contained 60 cases who had routine three phase enhanced scanning. The results of surgical operation were correlated with pathology. Ninety cases were ccRCC confirmed by pathology. Among these 90 cases, 44 cases were in the experimental group, 46 cases were in the control group. The degree of contrast of the tumor and the normal kidney in each phase were compared and also the radiation dosage were calculated. Results: ①Compared the mean CT value of the ccRCC of the experimental group in the cortico-medullary phase(CMP), nephrographic-excretory phase(N-EP) and the CMP, N-EP of the control group had no significant difference(P=0.064, P=0.105); Compared the mean CT value of N-EP in ccRCC of the experimental group and the NP of that in the control group had significant difference(P=0.000). ②The mean CT value in the CMP of the normal kidney in the experimental group compared with that of the control group had no significant difference(P=0.105). The CT value in the N-EP of the normal kidney in the experimental group compared with the mean CT values of nephrographic phase(NP), and excretory phase(EP) of the normal kidney in the control group had significant differences(P=0.000, P=0.001). ③In the experimental group, the average effective radiation dosage was 15.25 mSv. There was 30% less than the radiation effective dose of the control group. Conclusion: The split bolus MDCT enhancement examination can accurately diagnosed ccRCC, and at the same time, the effective dosage decreased obviously. There is important clinical application value of the method.
关键词
肾肿瘤 /
腺癌 /
透明细胞 /
体层摄影术 /
螺旋计算机
Key words
Kidney neoplasms /
Adenocarcinoma /
clear cell /
Tomography /
spiral computed
时 代;郑晶晶;张雪宁;李 亮;吴梦琳;刘美洲;励贺文;牛冬梅;魏 璐.
CT分次团注双期增强扫描在肾透明细胞癌中的应用[J]. 中国临床医学影像杂志. 2014, 25(1): 32-36
SHI Dai;ZHENG Jing-jing;ZHANG Xue-ning;LI Liang;WU Meng-lin;LIU Mei-zhou;LI He-wen;NIU Dong-mei;WEI Lu.
The application of split bolus CT enhancement in renal clear cell carcinoma[J]. Journal of China Clinic Medical Imaging. 2014, 25(1): 32-36
中图分类号：
Ｒ737.11
R730.261
Ｒ814.42
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