肾癌的CT诊断

CT diagnosing of renal cell carcinoma

目的：分析肾癌的CT影像特征,提高对肾癌影像诊断的认识。方法：回顾性分析28例经手术及病理证实的病例,患者均行CT平扫及增强扫描（皮质期15-25 s及实质期65-75 s）,对其CT表现及鉴别诊断进行探讨。结果：28例中肾透明细胞性肾细胞癌23例,乳头状细胞癌4例,肾血管平滑肌脂肪瘤（RAML）误诊肾癌（RCC）1例。其中小肾癌15例。多数突出肾轮廓外,平扫多数表现为低或等密度,少数表现为高密度。部分病例可见坏死囊变、钙化。增强扫描大多数皮质期明显强化,实质期迅速消退。结论：肾癌CT增强扫描多表现为快进快退的特征性影像表现。CT扫描还可为肾癌分期及临床制定治疗方案提供可靠依据。

Objective To analyze renal cell carcinoma（RCC） imaging character and increase imaging diagnostic cognition with RCC.Method Retrospectively analysis was made on 28 surgical and pathological proved cases.CT plain scan and enhancement scanning were performed（cortical phase and parenchymal phase） to explore CT feature and differential diagnosis.Results The clear cell renal cell carcinoma（CCRCC）in 23 cases of 28 cases,papillary RCC in 4 cases,renal angiomyolipoma（RAML） were misdiagnosed of RCC in 1 case,small RCC in 15 cases. Majority protruded adumbration of the kidney. Plain scan generality showed slightly lower or isodensity. Part cases of necrosis, cystis and calcif. Generality obviously enhancement in cortical phase, parenchymal phase rapidlly became decrease. Conclusion The RCC CT imaging feature of enhancement scanning generality to show ＂quick to advance and quick to retire＂. CT scan provides reliable warrantly for RCC staging and clinical devising the operative and the treatment procedure.