肾乳头状细胞癌CT平扫联合增强扫描的影像学特征分析

Image features of CT plain scan combined enhancement scan in papillary renal cell carcinoma

目的探讨多层螺旋CT平扫联合增强扫描对肾乳头状细胞癌的诊断价值。方法回顾性分析34例经手术病理证实的肾乳头状细胞癌的CT平扫及三期动态增强CT表现,分析肿瘤的形态、大小、密度、强化特点和程度(均匀强化、周围强化及不均匀强化)及肿瘤扩散情况(肾周侵犯、淋巴结转移及肾静脉侵犯)。结果 34例患者皮质期CT值为(49.8±15.3)HU;实质期肿瘤边界最清楚,CT值为(55.3±16.7)HU,延迟期CT值为(57.6±14.8)HU,16例肿瘤内可见不同程度的坏死、囊变及出血,5例患者发生转移。结论肾乳头状细胞癌肿瘤较小,密度均匀,肿瘤较大时易出现囊变和坏死,钙化多见,增强扫描后呈不均匀轻-中度持续性强化,有助于术前诊断。

Objective To evaluate the value of multi-slice spiral computed tomography（MSCT）scan combined enhancement scan in the diagnosis of papillary renal cell carcinoma. Methods A retrospective study was conducted on the findings of plain CT scan and triphasic dynamic contrast enhanced CT scan of 34 patients with papillary renal cell confirmed pathologically. Analyzed the tumor morphology,size,density,enhancement characteristics and pattern（homogeneous, peripheral or heterogeneous）and tumor spreading pattern（perinephric invasion, lymphadenopathy or venous invasion）. Results The CT value of the cortical phase of 34 patients was（49.8±15.3）HU, the tumor boundary in the parenchymal phase was the most clear, the CT value was（55.3±16.7）HU, and the CT value of the delay period was（57.6±14.8）HU. 16 cases showed different degrees of necrosis, cystic degeneration and hemorrhage, and 5 cases metastasized. Conclusion Papillary renal cell carcinoma has a small homogeneous density,and the bigger tumor is more prone to cystic necrosis, calcification is more common,continued light to moderate enhancement on MSCT scan, which is helpful for the diagnosis.