乳头状肾癌的CT表现

CT Findings of Renal Papillary Carcinoma

目的:探讨乳头状肾癌的多层螺旋CT(MSCT)表现及临床病理特点,旨在增强对其认识,提高乳头状肾癌的CT诊断水平。方法:搜集2015年3月-2018年6月期间经手术或穿刺病理证实的26例乳头状肾癌患者的CT图像及临床病理资料,进行回顾性对照分析,总结乳头状肾癌的CT表现并进行鉴别诊断。结果:26例乳头状肾癌中,单发26例,其中左肾18例,右肾8例;左右肾多发1例;发生于肾上极17例,肾下极7例,肾中极2例。CT表现为局限性肾内肿块19例,表现为肾皮质隆起肿块7例;平扫为均匀低密度影11例,有不均匀坏死9例,有斑点钙化灶6例;增强后皮质期肿块显著强化2例,轻中度强化24例;髓质期26例均表现为轻度强化。肿块侵犯肾盂3例,伴腹膜后肿大淋巴结5例。结论:多层螺旋CT多期增强扫描对乳头状肾癌的诊断有重要价值,增强强化程度较轻,可伴有斑点钙化灶,术前诊断较难明确,最终诊断依赖于病理检查。

Objective:To investigate the features of multislice spiral CT(MSCT) and its clinicopathological features in the diagnosis of papillary renal carcinoma.Methods:CT images and clinicopathological data of 26 patients with papillary renal carcinoma confirmed by operation or puncture pathology from March 2015 to June 2018 were collected.The CT findings of papillary renal carcinoma were summarized and differentiated.Results:Of the 26 cases of papillary renal carcinoma,26 cases were single,including 18 cases of left kidney and 8 cases of right kidney.Left and right renal multiple cases;Occurs in 17 cases of upper renal pole,7 cases of lower renal pole,and 2 cases of middle renal pole.CT findings included 19 cases of localized intrarenal mass and 7 cases of renal cortical uplift.There were 11 cases with uniform low density,9 cases with uneven necrosis and 6 cases with spot calcification.2 cases were significantly strengthened and 24 cases were slightly and moderately strengthened.Mild strengthening was observed in 26 patients during medullary period.Tumor invasion of renal pelvis in 3 cases,accompanied by retroperitoneal enlargement of lymph nodes in 5 cases.Conclusion:Multislice spiral CT multiphase enhanced scan has important value in the diagnosis of papillary renal carcinoma.The degree of enhancement is light,and it can he accompanied by speckle calcification.The preoperative diagnosis is difficult to be clear,and the final diagnosis depends on pathological examination.