多房囊性肾透明细胞癌的常见螺旋CT征象

Frequent spiral CT signs of multilocular cystic renal cell carcinoma

目的研究分析多房囊性肾透明细胞癌SCT征象、病理特点及诊断价值。方法回顾性分析经手术病理证实的18例多房囊性肾细胞癌(MCRCC)SCT征象。结果所有肿瘤呈圆形或类圆形,囊壁薄,边缘光整,囊内液性成分密度多略高于水;间隔边缘毛糙。MCRCC间隔菲薄型(6例),间隔增厚型(8例),间隔结节型(4例)。SCT动态增强显示菲薄间隔多呈轻到中度强化,结节型表现为明显均匀强化,增厚型间隔则有上述两种形式强化。结论MCRCC的典型影像特征为多囊液性密度、分隔毛糙和壁结节;囊壁薄而规则,多有轻到中度以上强化。SCT在MCRCC的诊断中具有重要作用,但鉴别时仍有一定难度。

Objective To investigate the frequent spiral CT signs and ipathologic features of muhilocular cystic renal cell carcinoma （MCRCC） and their significance for the diagnosis .Methods The spiral CT signs of 18 patients With surgically and pathologically proved MCRCC were analyzed retrospectively .Results All the lesions of MCRCC seen in 18 cases presented as round or round-like mass with thin cystic wall ,smooth- sharp border and intracystic fluid component of slightly higher density than water,however the septal border of the lesions was hazy.Among 18 patients with MCRCC,thin septum type was found in 6,thick septum type in 8,and nodular septum type in 4.Spiral CT scan with dynamic contrast enhancement showed that thin septum type was mild to moderate enhancement but nodular septum type was obviously homogeneous enhancement while thick septum type was coexistent of above two enhanced patterns.Conclusion The typical imaging features of MCRCC lesions are muhilocular mass with fluid density,hazy septum and mural nodule,while the cystic walls are thin and regular mostly associated with mild to moderate enhancement.SCT plays a significant role in the diagnosis of MCRCC but the differential diagnosis is still difficult.