肾嫌色细胞癌的CT与超声诊断

Imaging Diagnosis of Chromophobe Renal Cell Carcinoma

目的探讨肾嫌色细胞癌(chromophobe renal cell carcinoma,CRCC)的CT与超声表现特点,提高对本病的认识。方法回顾性分析36例经手术病理证实的CRCC,36例均行CT平扫或增强扫描,26例同时行超声检查。分析CRCC的CT平扫及动态扫描特点,并观察瘤体回声、包膜以及彩色血流超声表现。结果肿瘤实性成分平扫呈略高密度。动态增强扫描,9例、23例、4例分别于皮质期、实质期、延迟期强化程度最高。36例均表现为轻度强化。14例均匀强化,16例为不均匀强化,6例为周边强化。超声以低回声(18/26,69.2%)及中等实质回声(4/26,15.4%)为主,病灶内回声以不均匀多见(16/26,61.5%),包膜不明显,部分可见假包膜,大多侵犯局部肾包膜。瘤体中心及边缘以无明显血流(6/26,23.0%)或少量血流彩色为主(10/26,38.5%),部分富血供(8/26,30.8%),少数(2/26,7.7%)为中等血流分布。结论 CRCC的影像表现具有一定特征,综合分析其影像学表现,有助于提高该肿瘤的诊断准确率。

Objective To investigate the CT and US features of chromophobe renal cell carcinoma（CRCC）.Methods 36 cases of CRCC verified by pathological results were retrospectively analyzed.All of them received plain or enhanced CT scan.26 of them received US at the same time.The CT characteristics,the tumor＇s echo,envelope and the performance of color flow of CRCC were observed.Results The density of tumor solid component was slightly higher than that of normal renal cortex in the CT plan scan.On enhanced CT scans,9 cases,23 cases and 4 cases obtained the highest degree of enhancement in the cortex,substantial and delay period respectively.36 cases showed mild enhancement in which 14 cases wer homogeneous enhanced,16 cases were heterogeneous enhanced,6 cases were peripheral enhanced.Ultrasound mainly showed hypoechoic 69.2%（18/26） and moderate parenchyma echo 15.4%（6/26）,Lesions echo uneven 61.5%（16/26） commonly,the envelope was not obvious,pseudocapsules were visible partially,most of them violated the local renal capsule.The center and edge of the tumor had no apparent 23.0%（6/26） or a small amount 38.5%（10/26） blood flow,rich blood supply partly 30.8%（8/26）,a fewer cases with the medium blood flow distribution（7.7%,2/26）.Conclusion The image findings of CRCC are characteristic certainly,and are helpful to improve its diagnostic accuracy.