摘要
目的:探讨肾细胞癌边缘部CT征象与病理基础。材料与方法:搜集32例经手术病理证实的肾细胞癌,观察其术前边缘部的CT征象与术后病理改变对照。结果:(1)CT肿瘤边缘形态分3类:肿瘤边缘清楚无分叶(50%);边缘清楚伴分叶(28%);边缘不清(22%)。(2)肿瘤边缘病理分3种类型:包膜完整(48%);包膜不完整或锯齿状(33%);无包膜(19%)。(3)肿瘤平扫边缘不清者有7例,增强后病灶“缩小”或变清者占94.4%。(4)肿瘤边缘形态与癌细胞分级关系:边缘清楚无分叶或伴分叶者,癌细胞分级Ⅰ~Ⅱ级占81.8%,Ⅲ级占18.2%;边缘不清者,以Ⅲ级为主,占70%。结论:(1)CT肿瘤边缘3类形态恰与病理上肿瘤边缘3种类型相对应:即CT肿瘤边缘清楚无分叶者,病理上大多包膜完整;边缘清楚伴分叶者,病理上大多包膜不完整或锯齿状;边缘不清者,病理大多无包膜。因此,CT肿瘤边缘3类形态能较好地反映肿瘤包膜的完整程度以及肿瘤浸润情况。(2)CT平扫肿瘤边缘不清者,增强后肿瘤大多“缩小”或边缘变清,边缘不清是肿瘤周围正常肾实质内散在浸润的癌细胞所致,对于指导手术范围有一定帮助(手术应略扩大范围)。(3)CT平扫肿瘤边缘清楚无?
Objective: To study the CT features of renal cell carcinoma (RCC) and their pathologic basis. Materials and Methods: CT and pathologic findings were compared and analyzed in 32 patients with pathologically proved RCC. Results: (1) On CT scan, the tumor margin presented three patterns: clear margin and without lobulation (50%); clear margin and lobulated (28%); blur margin (22%). (2) Pathologically, the tumor margin could be classified into types: intact capsule (48%); incomplete capsule or serrated margin (33%); without capsule (19%). (3) On enhanced CT scan, the size of lesions with blur margin on plain scan was decreased in 7 cases. Conclusion: (1) CT can well demonstrate the tumor margin, and is well correlated with the pathologic findings. (2) CT pattern of RCC margin is very helpful in assessing the extent of tumor invasion and in grading the tumor cells.
出处
《临床放射学杂志》
CSCD
北大核心
1999年第6期354-357,共4页
Journal of Clinical Radiology