肾转移瘤的CT诊断及鉴别诊断

The CT diagnosis and differential diagnosis of metastatic tumor of kidney

目的:分析肾转移瘤的CT表现,以提高其CT诊断及鉴别诊断能力。方法:回顾性分析13例经穿刺活检或手术病理证实的肾转移瘤的临床及CT资料,所有病例术前均行CT平扫及增强扫描。结果:13例肾转移瘤单发8例,多发5例,共发现19个病灶:呈圆形或椭圆形16个,不规则形3个;囊实性11个,囊性6个,实性2个;直径2.2～8.7cm,<3.0cm 12个,3.0～5.0cm 5个,5.0～10.0cm 2个;位于肾皮质且突出肾皮质引起肾轮廓改变1个,位于肾实质16个(病灶中心多位于皮髓交界处),位于肾窦2个;增强扫描皮髓交界早期呈中等强化,实质期持续强化,17个病灶呈环状强化,环壁较厚,环外壁光整,内壁模糊,病灶内部强化不均,2个实性病灶隐约可见环状强化,病灶内部强化较均匀。结论:结合肾转移瘤的临床及CT双期增强表现,有助于该病的诊断和鉴别诊断.

Objective：To evaluate the MDCT features and differential diagnosis of renal metastasis. Methods：The clin ical and CT data of 13 cases with renal metastasis confirmed by biopsy or surgical pathology were reviewed and analysed retrospectively. All the patients underwent dynamic CT scan before operation. Results： A total of 19 metastatic lesions were identified in the 13 patients. Being solitary in 8 patients and multiple in 5 patients. Sixteen lesions appeared as round or ellipse and 3 as irregular shape. Eleven lesions were solid and cystic, 6 were cystic and 2 were solid. The diameter of the tumors was 2.2-8.7cm with 12 cases 〈3.0cm,5 cases 3.0-5.0cm and 2 cases 〉5cm. One tumor was located in the peripheral cortex,16 in the central medulla and 2 in the renal sinus. Tumors showed moderate enhancement at corticomedul lary phase and persistent enhancement at nephrographic phase. Ring shape enhancement was presented in 17 lesions with smooth outer wall and irregular inner wall. And indistinct ring shape enhancement was presented in 2 lesions with homogenous enhancement. Conclusion： The accuracy of CT diagnosis and differential diagnosis can be improved by the understanding of these dynamic CT findings and clinical features.