螺旋CT多期扫描在小肾癌诊断中的应用价值研究

Application of spiral CT scan in the diagnosis of small renal cell carcinoma

目的探讨螺旋CT多期扫描在小肾癌诊断中的价值。方法回顾分析16例经病理证实的小肾癌在平扫、皮质期、实质期及肾盂期的螺旋CT表现。结果CT平扫中1例病灶呈稍高密度,10例为等密度,4例为略低密度,1例为囊实性肿块。增强扫描皮质期12例强化程度高于或相当于正常肾皮质,2例强化低于肾皮质但高于肾髓质,1例强化程度等于肾髓质,1例囊实性病例囊壁明显强化。肾实质期扫描肿瘤密度迅速减退,肾盂期扫描肿瘤密度进一步减退。结论螺旋CT多期扫描对小肾癌是可靠有价值的诊断方法,特别是小肾癌皮质期强化明显,实质期强化迅速减退,呈"快进快退"表现,有重要的定性意义。

Objective To study the diagnostic value of spiral CT scan in small renal cell carcinoma.Methods The spiral CT features of 16 SRCCs proved by pathology were studied retrospectively. Results 1 patient＇s CT showed slightly hyperdense mass,10 with isodense,4 with slightly hypodense, and 1 with cyst and solid mass.After administration of contrast media,in cortical phase the tumor was enhanced,combined with higher and the same degree to the cortex in 12 SRCCs,with lower degree to the cortex but higher degree to the medullary in 2 SRCCs,with the same degree to the medullary in 1 SRCCs.In cortical phase the cyst wall showed marked enhacement in the cyst and solid case.In parenchymal phase the tumor density drops promptly,and in the pelvic phase the tumor density drops further.Conclusions The multi-phasic spiral CT scan is valuable in the diagnosis of small renal cell carcinoma.In most patients tumor enhacement was marked in cortical phase but less in parenchymal phase,the phenomenon of ＂quick staining and quick fainting＂ which is a characteristic pattern of enhancement is significant in diagnosis of small renal cell carcinoma.