囊性肾癌的影像分析

目的：讨论各种影像检查对囊性肾癌的诊断价值。方法：对经影像检查并得到病理证实的囊性肾癌15例进行分析,其中5例行静脉肾盂造影（IVP）,15例行B超及CT检查,14例同时行增强扫描,比较各种检查方法对囊性肾癌的检出率。结果：15例中,IVP检查诊断符合3例（60．0％）,B超诊断符合12例（80．0％）,CT扫描诊断符合13例（86．6％）。结论：联合影像学检查可提高囊性。肾癌的术前诊断率。     

MR对肾癌Ⅰ期瘤栓的诊断价值

目的评价MR对肾癌1期瘤栓的诊断价值。方法22例经手术病理证实的肾癌患者,均于术前行MR检查,观察肾静脉内和下腔静脉内有无瘤栓及瘤栓的范围,并与手术结果进行对照。评价MR对肾静脉和下腔静脉的显示情况及对肾癌I期瘤栓的诊断准确性。结果22例患者,均为单侧肾癌。手术病理共发现8处肾静脉瘤栓,无下腔静脉内瘤栓。MR对肾癌的检出率为100%。MR对21支肾静脉显示清楚,1支肾静脉显示不清。在显示清楚的21支肾静脉中,MR诊断8支肾静脉内有瘤栓,13支肾静脉内无瘤栓,均与手术病理符合。1支显示不清的肾静脉内,手术未见瘤栓。MR对22支下腔静脉均显示清楚,未见瘤栓。22例肾癌中,9例行增强CT检查,对瘤栓的诊断正确7例,漏诊1例,误诊1例。16例行超声检查,对瘤栓的诊断正确13例,误诊2例,漏诊1例。4例行DSA检查,诊断正确4例。结论MR对肾癌Ⅰ期瘤栓的诊断准确性高,当术前MR对肾静脉显示清楚时,MR可作为术前I期瘤栓评价的金标准。     

肾癌下腔静脉癌栓的诊断与治疗

肾癌下腔静脉癌栓的诊断与治疗４７１００３洛阳洛阳医学高等专科附属医院霍庆祥，王晓雄关键词肾肿瘤，下腔静脉，栓塞中国图书资料分类号Ｒ７３７．１１肾癌容易发生肾静脉和下腔静脉内癌栓（ＩＶＣ），近年作者诊治４例。１临床资料１．１一般资料本组４例ＩＶＣ，占同...     

Ultrasonography in the diagnosis and classification of renal cell carcinoma complicated with inferior vena cava tumor thrombus

目的:探讨常规超声、彩色多普勒超声、超声造影及术中超声在肾癌合并下腔静脉癌栓的诊断及临床分型中的应用价值.方法:对7例肾癌合并下腔静脉癌栓的患者进行常规超声、彩色多普勒超声检查,其中3例行超声造影检查,3例行术中超声检查.所有病例均经手术及病理证实.结果:所有下腔静脉栓子均为癌栓,癌栓分型为Ⅱ型4例,Ⅲ型2例,Ⅳ型1例.结论:超声技术对肾癌合并下腔静脉癌栓的诊断与鉴别诊断具有重要价值,并且能够脉对癌栓进行准确分型,对临床手术治疗及预后判断具有指导性意义.     

肾上腺常见肿瘤的MRI与CT对照研究

目的：将肾上腺常见肿瘤的MRI影像学特征与CT进行比较,结合病理诊断和生化结果评价MRI在肾上腺肿瘤诊断中的价值。方法：对我院于2000年5月-2008年6月收治并经病理证实的36例肾上腺肿瘤进行回顾性分析,所有病例均有详尽的MRI／及CT影像资料。结合病理,分析MR／和CT的影像特点。结果：36例中,CT和MRI发现阳性率分别为94％和100％;肾上腺癌及转移瘤10例,CT及MRI诊断准确率分别为4／10、10／10,其中,肾上腺癌伴腔静脉癌栓6例,CT和MRI诊断准确率分别为33％和100％。结论：CT和MRI在肾上腺肿瘤的诊断和鉴别诊断上有很好的互补性,MRI对良、恶性肿瘤的鉴别诊断价值及对静脉腔瘤栓的显示上优于CT。     

超声技术在肾癌合并下腔静脉癌栓诊断中的应用

目的:探讨常规超声、彩色多普勒超声、超声造影及术中超声在肾癌合并下腔静脉癌栓的诊断及临床分型中的应用价值。方法:对7例肾癌合并下腔静脉癌栓的患者进行常规超声、彩色多普勒超声检查,其中3例行超声造影检查,3例行术中超声检查。所有病例均经手术及病理证实。结果:所有下腔静脉栓子均为癌栓,癌栓分型为Ⅱ型4例,Ⅲ型2例,Ⅳ型1例。结论:超声技术对肾癌合并下腔静脉癌栓的诊断与鉴别诊断具有重要价值,并且能够脉对癌栓进行准确分型,对临床手术治疗及预后判断具有指导性意义。     

螺旋CT薄层多平面重建在肾癌诊断与分期中的作用

目的分析肾癌的螺旋CT表现,探讨SCT薄层多平面重建在肾癌诊断及分期中的价值。方法在33例中利用SCT薄层多平面CT征象所见与手术病理结果对照。结果SCT薄层多平面分期扫描显示最小肿瘤特征,Ⅰ期5例,Ⅱ期10例,Ⅲ期9例,Ⅳ期9例,与手术病理对照,准确率为87．87％。结论SCT薄层及多平面重建的方法可准确显示肾癌的特征与邻近浸润及肾静脉与下腔静脉内癌栓表现,提高诊断与分期的符合率。     

小儿肾发育不良的超声诊断

目的：探讨超声诊断小儿先天性肾发育不良的临床应用价值,提高肾发育不良的超声诊断水平。方法：回厕性分析30例经手术病理证实的肾发育不良患者的影像学资料,所有患者均行超声检查,21例行静脉肾盂造影（IVP）描查,2例行排尿膀胱尿道造影（VCU）检查,4例行CT平扫,2例行CT平扫及增强扫描。分析小儿肾发育不良的超声稍点,并与其它影像学检查结果进行对照分析。结果：30例患者超声均诊断正确,诊断符合率为100％。30例中患肾异枉26例,患肾实质结构不良26例,实质内检出囊泡者28例。30例中合并输尿管远端开13异位20例,合并其它泌尿系畸呒7例。IVP检出患肾2例（2／21）,CT增强扫描栓出患肾1例,VCU提示膀胱输尿管返流1例。结论：超声诊断肾发育环良准确有效,是值得推荐的影像学检查方法。     

肾癌的螺旋CT双期扫描及CT分期

目的：探讨肾癌的螺旋CT双期扫描表现及CT分期的价值。方法：对36例手术病理证实的肾癌患者CT双期扫描图像进行分析。结果：CT平扫等密度者17例，低密度者15例，高密度者4例；增强扫描动脉期呈均质强化者7例，不均质强化者29例；高强化者27例，弱强化者9例；实质期肾静脉癌栓者10例(占28％)，下腔静脉癌栓者3例，淋巴结转移者6例。结论：螺旋CT双期扫描可对肾癌做出明确诊断，CT分期对指导治疗方案有较大价值。     

输尿管囊肿影像学诊断价值(附18例分析)

目的：探讨输尿管囊肿影像学诊断的价值。方法：应用B超、CT、静脉尿路造影(IVU)综合检查，诊断18例输尿管囊肿合并重肾双输尿管畸形，并与手术结果进行对比。结果：B超、CT、IVU均诊断18例为输尿管囊肿。其中，B超均可显示囊肿大小及变化；CT诊断14例膀胱内外均呈囊性扩张，4例仅膀胱内输尿管囊性扩张，18例合并上肾积水，及重肾、双输尿管畸形。IVU诊断12例上肾积水，9例明确为重肾双输尿管畸形。结论：输尿管囊肿需经B超、CT、IVU联合诊断明确是否合并肾畸形及囊肿的分型，指导治疗方案的制定。     

Co-existent renal eosinophilic granuloma and renal adenocarcinoma

Localized renal eosinophilic granuloma has not been previously reported. In this patient there was osseous eosinophilic granuloma and a 1 cm hypervascular renal lesion which pathologically proved to be coexistent renal adenocarcinoma and eosinophilic granuloma.     

Percutaneous transluminal renal angioplasty and renal function

Renal function was studied before and after percutaneous transluminal renal angioplasty (PTRA) in 79 patients. In a prospective study of 28 patients with unilateral renal artery stenosis, renal function was similar during angiotensin-converting enzyme (ACE) inhibition and after PTRA. In 37 patients with bilateral renal artery stenoses, 9 patients with solitary kidneys and renal artery stenoses and 5 patients with transplant renal artery stenoses, there was no statistical difference in the renal function before and after PTRA. Of the 79 patients studied, 50 had normal renal function before PTRA. In 5 of these renal function decreased, requiring temporary hemodialysis in 1. Of 29 patients with impairment of renal function due to renal artery stenosis, improvement was noted in 14, stabilization of renal function in 11, and decrease of renal function in 4. It is concluded that PTRA is a safe technique that can make life-long drug treatment unnecessary in antihypertensive patients. It can restore or stabilize renal function in renal insufficiency caused by renal artery stenosis. It has to be kept in mind that contrast medium toxicity and cholesterol embolization can induce severe renal insufficiency after PTRA.     

Hemorrhagic renal angiomyolipoma: Superselective renal arterial embolization for preservation of renal function

A 35-year-old woman with tuberous sclerosis and known bilateral renal angiomyolipomas presented with shock due to massive hematuria arising from the left kidney. The cause of bleeding was diagnosed angiographically as arising from a left upper pole renal artery aneurysm within the tumor. Cessation of bleeding and clinical stabilization occurred without deterioration of renal function after superselective embolization of the dorsal segmental renal artery with a single 5-mm Gianturco coil.     

Primary renal angiosarcoma mimicking a renal cell carcinoma

Primary renal angiosarcoma is a very rare malignant tumor that closely mimics the more common renal cell adenocarcinoma (hypernephroma) in radiologic appearance. Both tumors are hypervascular masses and the diagnosis must be confirmed histologically. However, in the presence of a tumor with a capsular blood supply, and in the absence of venous invasion, the diagnosis of renal angiosarcoma may be suggested, especially in a patient with a new onset of consumption coagulopathy.