37例肾占位病变的CT分析

CT Analysis of 37 Cases of Renal Space Occupying Lesions

目的：分析肾占位病变的CT表现，探讨肾占位病变的诊断与鉴别。材料与方法：回顾性地观察37例肾占位性病变的CT资料，重点对以向外生长为主的肾肿瘤CT表现、肾癌的密度与肿瘤细胞类型的关系进行了分析。结果：3例向外生长的肾血管平滑肌脂肪瘤显示脂肪密度伴肾包膜下积血；6例透明细胞癌中4例平扫为略高密度或高密度，CT值48～69Hu；两例肾盂癌表现为肾窦中央及边缘10mm左右等密度社伴轻度积水及增强后低密度改变。结论：肿瘤脂肪成份伴肾包膜下积血可作为向外生长为主的肾血管平滑肌脂肪瘤的诊断依据；高密度的肾肿瘤与细胞类型有关；对肾盂癌进行薄层、增强后早期十延迟扫描直至肾盂充盈是十分必要的。

Purpsse: Analysing the CT manifestation of the renal space occupving lesbo and discussing the diagnesis and differntial diagnosis of these lesions. Materials and Methods: 37 cases of renal space occupving lesions were observed retrospectively, the CT manifestation and the reationship betwee the density and the cell types of the tumor of the kidney were especially analysed. Results: 3 cases of reed angiomyolipoma which growing against the kidney show fatty density acopboed by subcapsular hematoma; 4 of 6 cases of clear cell carcinoma show slightly of apparently hyperdensity with the CT value between 48~ 69 Hu; 2 cases of pyelic cardnoma show about 16mm in diameter isodense lesions in the center or edge of the sinus renalis accompied by slightiy renal hydronehrosis and hypodensity when enhanced. Conclusion: The fatty tissue together with the subcapsular hematoma can be considered as the bass to diagnose the aengiomyolipoma which growing against the kidney, The renal tumors with hyperdensity are reated with ther cell types; it is essetial to scan the pyelic cardnoma with thin thickness and eary phase scanning together with delayed scanning until the pelvis renalis is fully filled.