MCRCC患者螺旋CT动态双期增强扫描强化特征与临床病理对照研究

Comparative study of enhancement characteristics and clinicopathology of MCRCC patients with dynamic dual-phase enhanced spiral CT

目的探讨低度恶性潜能多房性囊性肾肿瘤(MCRCC)患者的螺旋CT皮髓交界期、实质期动态增强扫描强化特征。方法经手术病理证实的21例MCRCC患者行全肾平扫后,分别于开始注射对比剂后20 s、80 s行全肾螺旋CT皮髓交界期和实质期增强扫描,观察其囊壁、间隔及壁结节在各期的强化特征。结果21例MCRCC患者肿瘤成分均为囊性部分较多且实性部分较少,由多个囊腔及分隔构成。病变的囊壁、间隔及壁结节均见不同程度强化,表现为"快进缓出"型,尤其以"缓慢上升"型多见。结论低度恶性潜能多房性囊性肾肿瘤临床上通常无典型症状,影像学表现缺乏特异性,而囊肿穿刺细胞学检查常呈阴性,容易漏诊。螺旋CT双期动态增强扫描,癌灶的囊壁、分隔及壁结节的强化特征有助于其准确诊断,也是与其他伴有囊性成分肾肿瘤的主要鉴别诊断方法。

Objective Investigate the enhanced features of low-grade malignant multi-atrial cystic renal tumor(mcrcc)in spiral ct cortical junction,parenchymal phase dynamic enhancement scan,select a reasonable preoperative treatment regimen and predict its prognosis.Methods 21 cases of low-grade malignant polyatrial cystic renal tumor were treated with total renal plain scan,and 20 s and 80 s of total renal helix ct cortical junction and parenchymal enhancement were performed respectively.To observeThe enhancement features of cyst wall,septum and nodules of low malignant potential polyatrial cystic renal tumor were observed.Results The components of 21 cases of MCHC tumors were more cystic and less solid,with multiple cystic cavities and separations.The cyst wall,spacer and wall node of the lesion were enhanced to varying degrees,and It is shown as"fast in and slow out"type,especially"slow rising"type.Conclusion low-grade malignant multi-atrial cystic renal tumor usually has no typical symptoms,lack of specificity in imaging findings,and cyst puncture cytology is often negative,easy to miss diagnosis.Multi-stage spiral CT enhanced cyst wall,separation and enhancement of wall nodules are helpful for the accurate diagnosis of low-grade malignant multi-atrial cystic renal tumor.