多层螺旋CT三期增强扫描对肾癌的诊断价值

Tri-phase enhancement spiral CT scanning in the diagnosis of renal cell carcinoma

目的探讨肾癌多层螺旋CT三期增强扫描征象,提高诊断水平。方法回顾性分析87例经手术病理证实的肾癌多期螺旋CT扫描资料。将CT征象与手术病理结果进行对照分析。结果典型肾癌表现为大小不等的肾肿块,多为等或稍低密度,巨大者呈混杂密度,小肾癌(直径≤3 cm)可有假包膜。增强扫描皮质期显著强化54例,轻中度强化33例,实质期肿瘤密度迅速减低,肾盂期肿瘤密度进一步减低。三期增强扫描易于显示肾周筋膜、肾盂、肾盏侵犯,肾静脉、下腔静脉癌栓及淋巴结、邻近器官转移。结论多层螺旋CT三期增强扫描可很好显示肾癌病灶内造影剂"快进快退"和假包膜等特征性表现,还可准确进行分期,为指导手术提供依据。

Objective To investigate the signs of renal cell carcinoma（RCC） ,and improve the imaging diagnosis of RCC with tri-phase enhancement helical CT scanning. Methods The plan and multislice spiral CT scan data of 87 patients with surgical-pathologically proved renal cell carcinoma were analyzed retrospectively. Results Typical RCC showed that renal masses were in different size,and isodensity to hypodensity in the most cases,heterogeneous density in giant cases. The pseudocapsules were showed in small RCC （φ≤3 cm）. The lesions showed marked enhancement in cortical phase in 54 cases, slight to moderate enhancement in 33 cases. The tumor density dropped promptly in parenchymal phase,and the tumor density dropped further in the pelvic phase. Renal fascia,renal pelvis and calices invasion,carcinomatous embolus of renal vein and IVC,metastasis of lymph node and adjacent organ was well showed in tri-phase incremental helical CT scan. Conclusion Tri-phase enhancement helical CT scanning well demonstrates the characterization of ＂quick staining and quick fainting＂ and the pseudocapsule,which is significant in the diagnosis of RCC. The CT staging of RCC provides much more information for clinical treatment.