螺旋CT在小肾癌诊断中的临床应用

Clinical application of helical CT scanning in the diagnosis of small renal carcinoma

目的 :评价螺旋 CT多期扫描在小肾癌诊断中的价值。方法 :分析 2 0例小肾癌的螺旋 CT表现及其病理基础。结果 :小实性肾癌 17例 ,增强扫描皮质期 13例呈明显强化 ,4例呈轻中度强化 ;小囊性肾癌 3例 ,增强后皮质期囊壁、壁结节、囊内分隔明显强化。实质期及肾盂期强化迅速减退 ,呈“快进快退”改变。病理上所有病例血窦丰富 (3例小囊性肾癌囊变明显 ,但实性部分血窦丰富 )。结论 :螺旋 CT多期扫描在小肾癌的诊断中较常规 CT有明显优越性 ;多数小肾癌皮质期强化明显、实质期强化迅速减退 ,呈“快进快退”表现 ,这一强化形式有定性意义 ;皮质期扫描应纳入小肾癌

Objective:To evaluate helical CT scanning in the diagnosis of small renal carcinoma.Methods:Helical CT features and pathologic findings of 20 patients with small renal carcinoma were analyzed.Results:Of 17 cases of small solid renal carcinoma,13 showed marked tumor enhancement in cortical phase.In another 4 cases the enhancement was slight to moderate.Three cases of small cystic renal carcinoma,presented wall enhancement with nodules and the partition in cortical phase.Enhancement faded away in the following parenchymal phase and pyelographic phase.All cases had hypervascular appearance pathologically.Three cases of small cystic renal carcinoma showed clear cystic degeneration,but the solid portion was rich in vascularity.Conclusion:The multi-phasic helical CT scanning is superior to the conventional CT in the diagnosis of small renal carcinoma. In most cases,tumor enhancement was strong in cortical phase but weak in parenchymal phase,they demonstrated some degree of fast wash-out phenomenon,which is a characteristic pattern of enhancement.And we believe this has diagnostic significance.Therefore,the acquisition of a cortical phase scanning should be part of the routine helical CT protocal of small renal carcinoma.