多层螺旋CT增强扫描对肾癌亚型的诊断价值

Diagnostic value of multi-slice helical CT for differentiating renal cell carcinoma

目的探讨常见肾癌亚型多层螺旋CT增强扫描表现,提高诊断准确率。方法回顾性分析55例经手术病理证实的且有完整临床资料的肾癌的MSCT表现特点。结果 3种肾癌亚型平扫CT值无统计学差异。在增强扫描皮髓质期、肾实质期及排泄期,透明细胞癌的CT值均高于乳头状癌和嫌色细胞癌,不均匀强化最常见于透明细胞癌,均匀强化最常见于嫌色细胞癌。结论肾透明细胞癌与其他亚型鉴别具有一定的价值,但不典型的乳头状癌与嫌色细胞癌较难鉴别。

Objective To evaluate MSCT features in the diagnosis of renal cell carcinoma. Methods MSCT appearance of 55 cases with renal cell carcinoma confirmed by surgery and pathology were retrospectively analyzed. Results CT attenuation on unenhanced scan was not statistically different between three subtypes. CT attenuation of clear cell carcinoma was higher than that of papillary and chromophobe renal cells in corticomedullary, nephrographic and excretory phase. Homogeneous and heterogeneous enhancement was most commonly seen in chromophobe renal cell and clear cell carcinoma. Conclusion Dynamic enhanced CT scan is effective method for differentiating clear cell carcinoma from non - clear cell carcinoma, but it is difficult to identify atypical papillary carcinoma and chromo- phobe carcinoma.