多层螺旋CT对肾细胞癌侵犯肾包膜的评价

Evaluation of multi-slice spiral CT (MSCT) of renal cell carcinoma with the invasion of the renal capsule

目的:探讨多层螺旋CT(MSCT)对肾细胞癌侵犯肾包膜的评价效果。方法:收集114例经手术病理证实的肾细胞癌,回顾分析其CT表现,并与手术病理对照。结果:114例肾细胞癌中,≤3cm24例(无肾包膜受侵),3～5cm32例(肾包膜受侵3例),≥5cm58例(肾包膜受侵29例)。32例肾包膜受侵病例CT表现为:边缘锯齿征22例、深分叶10例、浅分叶7例、光整2例,脂肪囊内网线影19例、结节/肿块9例;82例肾包膜未受侵病例CT表现:边缘光整57例、浅分叶16例、深分叶2例、锯齿征2例,脂肪囊内网线影17例、无结节/肿块。结论:肾细胞癌大小,边缘是否光整,有无锯齿征及深分叶征,肾周脂肪囊内有无软组织密度结节及网线影是判断肾细胞癌侵犯肾包膜的重要指标。MSCT高分辨薄层扫描技术的应用,能较好的判断肾细胞癌对肾包膜的侵犯。

Objective：To study the value of multi-slice spiral CT （MSCT） in the diagnosis of renal cell carcinoma with the invasion of the renal capsule. Methods： 114 eases with renal cell carcinoma proved by surgery and pathology were collected. CT findings and postoperative pathological results of the fringe of renal capsule and perirenal adipose capsule were retrospectively compared and analysed. Restalls： In tiffs cases, 3 cm or less, 3-5 cm, 5cm or more of renal tumor＇s long-diameter are respectively 24 eases（not invased with the renal capsule）, 32 cases（3 eases invased）, 58 eases（29 cases invased）. CT findings of invasion of the renal capsule in 32 eases, there are respectively 22 cases, 10 eases, 7 eases, 2 eases, 19 eases, 9 cases to appear correspondingly sawtcoth sign, deep sublobe, light sublobe, smoothing of the renal capsule and net signs, nodule or mass in the perirenal adipose capsule. CT findings of not invasion of the renal capsule in 82 eases, there are respectively 57 cases, 16 cases, 2 cases, 2 cases, 17 eases to appear correspondingly smoothing, light sublobe, deep sublobe, sawtooth sign of the renal capsule and net signs in the perirenal adipose capsule, not nodule or mass. Condusion：Renal cell carcinoma＇s size, fringe （smoothing, sawtooth sign, deep sublobe or not） and perirenal adipose capsule （net signs, nodule, mass or not） are important and useful signs. Renal cell carcinoma with the invasion of the renal capsule can be better evaluated by using high resolution and thin-slice scan with multi-slice spiral CT.