螺旋CT多期增强扫描在肾癌诊断中的临床应用

目的探讨螺旋CT多期增强扫描对肾癌的临床诊断价值。方法回顾性分析本院2009年4月-2015年8月经病理证实115例肾癌患者的CT影像资料,观察CT图像表现,并以手术病理结果为对照,评价螺旋CT多期增强扫描对肾癌分期、分型的诊断价值。结果 CT诊断肾癌Ⅰ期50例,Ⅱ期35例,Ⅲ期20例,10~(-3)期10例,与手术病理结果对照,诊断总符合率80.0%。不同亚型肾癌患者CT平扫期、动脉期、实质期、排泄期CT值比较差异有统计学意义(P0.05)。透明细胞癌动脉期、实质期、排泄期CT值分别显著高于嫌色细胞癌、乳头状癌(P0.05)。乳头状癌平扫期CT值为(42.9±8.6)HU,显著高于透明细胞癌、嫌色细胞癌的(36.6±6.0)HU、(35.7±5.3)HU,差异有统计学意义(P0.05)。CT显示类圆形病灶84个;强化模式:透明细胞癌以不均匀强化为主,嫌色细胞癌以均匀强化为主。结论螺旋CT多期增强扫描因其密度、强化等特点对肾癌分期诊断准确率较高,有助于肾癌临床分型。

Clinical Application of Spiral CT Multi-Phase Enhanced Scan in Diagnosis of Renal Cancer

Objective To investigate the value of spiral CT multi-phase enhanced scan in the diagnosis of renal cancer.Methods The CT imaging data of 115 patients with renal cancer confirmed by pathology in our hospital between April 2013 and August 2015 were analyzed retrospectively.The CT findings were observed.With surgical and pathological results as control,the diagnostic value of spiral CT multi-phase enhanced scan in staging and typing of renal cancer was evaluated.Results CT diagnosis showed that there were 50 cases in stage Ⅰ of renal cancer,35 cases in stage Ⅱ,20 cases in stage Ⅲ and 10 cases in stage Ⅳ.Compared with surgical and pathological results,the total coincidence rate was 80.0％.There were significant differences in CT values of plain scan phase,arterial phase,parenchymal phase and excretion phase between patients with different subtypes of renal cancer (P＜0.05).The CT values of clear cell carcinoma in arterial phase,parenchymal phase and excretion phase were significantly higher than those of chromophobe cell carcinoma and papillary carcinoma (P＜0.05).The CT value of papillary carcinoma in plain scan phase (42.9 ± 8.6) HU was significantly higher than that of clear cell carcinoma and chromophobe cell carcinoma (36.6 ± 6.0) HU,(35.7 ± 5.3) HU] (P＜0.05).CT showed that there were 84 round lesions;In terms of enhancement pattern,clear cell carcinoma was with inhomogenous enhancement and chromophobe cell carcinoma with homogeneous enhancement.Conclusion Because of features such as density and enhancement,the accuracy rate of spiral CT multi-phase enhanced scan in diagnosis of clinical stage of renal cancer is high,which is helpful to the diagnosis of renal cancer.