多层螺旋CT动态增强扫描对不同类型小肾癌的诊断价值研究

Diagnosis Value of MSCT Dynamical Scanning for Different Types of Small Renal Carcinoma

目的:探讨多层螺旋CT动态增强扫描对不同类型小肾癌的诊断价值。方法:回顾性分析2013年4月至2016年4月间我院收治的经病理证实的小肾癌患者62例的CT平扫及三期动态增强扫描征象进行分析与比较。结果:肾透明细胞癌患者、肾乳头状细胞癌患者及肾嫌色细胞癌患者一般资料无统计学差异(P>0.05)。62例患者共检出低密度14例,等密度38例以及高密度10例。透明细胞癌以等密度居多(60.00%),乳头状细胞癌以等密度居多(70.43%),嫌色细胞癌以低密度居多(66.67%)。不同类型小肾癌患者CT平扫结果之间差异显著(P<0.05)。透明细胞癌以明显强化居多(77.14%),乳头状细胞癌以轻度强化居多(90.48%),嫌色细胞癌以中等强化居多(66.67%),不同类型间强化程度比较有统计学差异(P<0.05)。不同类型间强化模式以均匀强化及典型强化居多,三组差异不显著(P>0.05)。透明细胞癌三期CT值均显著高于乳头状细胞癌及嫌色细胞癌,差异有统计学意义(P<0.05),而乳头状细胞癌及嫌色细胞癌各期差异不显著(P>0.05)。三种类型小肾癌实质期CT值均显著高于其他两期,三期比较差异显著(P<0.05)。结论:多层螺旋CT动态增强扫描对于不同类型小肾癌的鉴别诊断具有积极的意义。

Objective： To explore the diagnosis value of multi-slice computed tomography （MSCT） dynamical scanning for differ- ent types of small renal carcinoma. Methods＂ 62 patients with small renal carcinoma accepted in our hospital t^om April 2013 to April 2016 were detected by CT scan and dynamical scanning, and the imaging results were analyzed and compared. Results： The basic data of patients with renal clear cell carcinoma, renal papillary carcinoma and renal chromophobe cellcarcinoma had no difference （P〉0.05）. There were 14 cases with low density, 38 cases with identical density and 10 cases with high density. The renal clear cell carcinoma and papillary carcinoma were mostly identical density （60.00 % and 70.43%）, but the chromophobe carcinoma were mostly low density （66.67 %） with statistically significance （P〈0.05）. The renal clear cell carcinoma were mostly obviously enhanced （77.14 %）, the papill- lary carcinoma were mostly slightly enhanced （90.48 %）, and the chromophobe carcinoma were mostly moderately enhanced （66.67 %） with statistically significance （P〈0.05）. The enhanced types of 3 groups were mostly even enhancement and typical enhancement without differences （P〉0.05）. The CT value of clear cell carcinoma were obviously higher than the other 2 types with statistically difference （P〈0. 05）, which the difference of the other 2 types had no statistically significance （P〉0.05）. The CT value of parenchymal phase of 3 groups were all higher than that of other 2 phases with statistically significance （P〈0.05）. Conclusions： MSCT dynamical scanning has positive significance in the diagnosis of different types of small renal carcinoma.