螺旋CT多期动态扫描对肾脏占位性病变的定性诊断价值探讨

Evaluation of differential diagnosis of renal massive lesions with multi-phase spiral CT

目的分析肾脏占位性病变的螺旋CT(SCT)多期表现,探讨螺旋CT多期扫描对该类疾病的定性诊断价值。方法对手术病理证实的45例肾脏占位性病变进行回顾性分析,所有病例均行平扫和增强扫描。结果肾恶性肿瘤29例,其中肾癌(RCC)27例,增强扫描呈动脉期明显强化,实质期为相对低密度;肾盂癌2例,增强后轻度强化或明显强化。良性肿瘤5例,均为肾血管平滑肌脂肪瘤(AML),4例可测得脂肪密度,增强后软组织部分强化,而脂肪成分不强化,SCT表现典型。其他11例,肾囊肿10例,表现为边界清楚的囊性病灶,增强后未见强化;结核性脓肾1例,表现为多发囊状低密度区,增强后呈环状轻度强化,低密度区未见强化。结论SCT多期增强扫描及必要时薄层扫描,对肾脏占位性病变的定性诊断有重要价值。

Objective To analyse the multi-phase Spiral CT findings of renal massive lesions and to the investigate the value of Spiral CT imaging in differential diagnosis of these diseases. Methods Fourty-five cases of renal massive lesions had been proven surgically were retrospetively analysed. Pre-and post-contrast CT scans were performed in all the cases. Results 29 of 44 cases were malignant tumors with 27 cases of renal cell carcinoma （RCC）. Five of 27 cases are irregular figure. All showed obvious enhancement in artery phase. Enhancement of RCC in Vein phase was a little lower than of renal cortical. Two of 29 cases were carcinoma of the renal pelvio with obvious or slingt enhancement. Five of 45 cases of benign tumors were angio- leiomyolipoma （AML）. Four of five cases, fat tissuedensity was found. The soft tissuse part of the tumor showed obvious enhancement while the area of tat did not show any enhancement with the contrast medium. SCT showed classic. Eleven of 45 cases with 10 cases of renal cysts showing as classic cystic lesions with clear margin; No enhancement was found. One of 11 cases tuberculo-renal abscess, appearing as multi-cystic 10 w density section and cyst with cricoid slight enhnancement while no enhance of low density section. Conclusions Multi-phase SCT scans and the thin-thickness mediun play an important roles on diagnosis of renal massive lesions.