128层螺旋CT增强检查对肾癌及肾盂癌的诊断及鉴别

Diagnosis and Differential Diagnosis of Renal Carcinoma and Renal Pelvis Carcinoma by 128 Slice Spiral CT

目的研究肾癌及肾盂癌采取128层螺旋CT增强检查的诊断及鉴别。方法取2018年1月—2019年6月的50例疑似肾癌及肾盂癌患者,行128层螺旋CT增强扫描,以病理检查结果为金标准。观察诊断符合率、CT图像特征。结果128层螺旋CT增强扫描诊断符合率为96.00%,扫描结果与病理检查结果的差异不具有统计学意义(χ2=0.355,P=0.837)。肾癌可见类圆形、圆形、不规则形病灶,等密度、稍高密度或稍低密度,部分肾盏肾盂受压变形,存在坏死、囊变,少数钙化灶,增强扫描早期不均匀明显强化。肾盂癌中,肾盂内肿块型:腔内肿块,边界清晰或模糊,密度不均匀或均匀;浸润肾实质型:肿块向肾实质侵犯,轮廓中度或轻度变形。结论肾癌及肾盂癌采取128层螺旋CT增强检查,诊断准确性高,且可有效鉴别诊断。

Objective To study the diagnosis and differential diagnosis of renal carcinoma and renal pelvis carcinoma by 128 slice spiral CT.Methods From January 2018 to June 2019,50 patients with suspected renal cancer and renal pelvis cancer were scanned with 128 slice spiral CT,and the pathological results were taken as the gold standard.The diagnostic coincidence rate and CT image characteristics were observed.Results The diagnostic accuracy of 128 slice spiral CT was 96.00%,There was no significant difference between the scanning results and the pathological examination results(χ2=0.355,P=0.837).Renal cancer can be seen as round,round,irregular lesions,isodensity,slightly high density or slightly low density,some calyces and renal pelvis are compressed and deformed,there are necrosis,cystic change,a few calcified lesions,uneven and obvious enhancement in the early stage of enhanced scanning.In the carcinoma of renal pelvis,intrarenal mass type:intrarenal mass,with clear or fuzzy boundary,uneven or even density;infiltrating renal parenchyma type:mass invading renal parenchyma,with moderate or slight contour deformation.Conclusion 128 slice spiral CT can be used to enhance the diagnosis of renal carcinoma and renal pelvis carcinoma.