囊性肾癌的CT诊断和鉴别诊断

CT Diagnosis and Differential Diagnosis of Cystic Renal Cell Carcinoma

目的:探讨囊性肾癌的CT表现特点,旨在提高诊断及鉴别诊断水平。方法:回顾性分析14例经手术病理证实的囊性肾癌CT影像学表现特点。结果:囊性肾癌14例中,单囊8例、多囊6例。囊壁增厚或厚薄不均11例,囊壁菲薄均匀3例。其中伴壁结节及分隔各4例、伴壁结节与分隔同时存在2例,分隔厚薄不均5例、纤细均匀1例。平扫肿瘤呈囊实性混杂密度12例、呈较均匀囊样低密度2例;囊液密度较高、隐约见碎屑、絮状物或明显出血9例,囊液均匀如水5例;肿瘤实性部分钙化3例。增强后肿瘤实性部分呈明显快进快退型强化11例,部分呈快进快退型强化合并部分中度进行性延迟强化1例,轻度强化2例。肾门或后腹膜淋巴结转移4例。结论:CT检查对囊性肾癌的诊断和鉴别诊断具有一定的临床实用价值。

Objective：To study the CT image features of cystic renal cell carcinoma （CRCC）,for the purpose of improving the level of diagnosis and differential diagnosis. Methods：CT imaging features of 14 cases of CRCC confirmed surgically and pathologically were analyzed retrospectively. Results：In 14 cases of CRCC, there were 8 cases of single-cystic and 6 cases of multi-cystic. The cystic wall was thickened and uneven in 11 cases, and even in 3 cases. There were mural nodule and septation in 4 cases each. In 2 cases there was coexistence of mural nodule and septation. The septation was uneven in 5 cases and fine and even in 1 case. On plain scanning cystic solid tumor of mixed density was found in 12 cases, cystic relatively homogeneous low-density in 2 cases,cystic liquid of high density with faint debris and floc and obvious bleeding in 9 cases,cystic liquid homogeneous as water in 5 cases, calcified solid part of tumor in 3 cases. After CT enhancement, the solid part of tumors was significantly enhanced with rapid-in and rapid-out type in 11 cases,and part of the tumor showed rapid- in and rapid-out type enhancement with woderate progressive delayed enhancement in one case. Renal hilum or retroperito- heal lymph gland metastasis was found in 4 cases. Conclusion：CT scanning plays important roles in the diagnosis and differential diagnosis of CRCC.