螺旋CT增强扫描和超声造影对多房囊性肾透明细胞癌的诊断价值

目的 分析多房囊性肾透明细胞癌(MCRCC)影像学征象和病理特点,提高其诊断准确性.方法 回顾性分析术前行螺旋CT(SCT)多期增强扫描和超声造影(CEUS)检查并经手术病理证实的18例MCRCC影像特征.结果 所有肿瘤呈圆形或类圆形,囊壁薄,边缘光整,囊内液性成分密度略高于水,间隔边缘毛糙.MCRCC间隔菲薄型6例,间隔增厚型8例,间隔结节型4例.SCT动态增强和CEUS均显示菲薄间隔多呈轻到中度强化,结节表现为明显均匀强化,增厚型间隔则有上述两种形式强化;肿瘤间隔的SCT强化程度与CEUS的峰值强度有明显相关性.结论 MCRCC的典型影像特征为多囊液性密度、分隔毛糙和壁结节,囊壁薄而规则,多有轻到中度以上强化.充分结合CEUS和SCT的多期增强扫描可以提高对MCRCC的诊断率,为临床治疗提供有力指导.

Diagnostic value of multilocular cystic renal cell carcinoma by contrast-enhanced scanning of Spiral CT and ultrasound

Objective To study the imaging features and pathological characteristics of MCRCC in order to improve its diagnostic accuracy. Methods The multi-phase SCT and contrast-enhanced ultrasound were performed in 18 cases of MCRCC proved by the pathology before their operation.The imaging features of MCRCC in 18 patients were reviewed. Results All tumors appeared as well-defined round or oval multilocular cystic masses composed of serous fluid with regular thin cystic wall and an irregular renal shape. There were thin coarse septum(6 cases), thick septum(8 cases) and septum with nodule(4 cases) of all the tumor. Dynamic SCT presented enhancement from slight to moderate degree in thin septum cases, obviously homogeneous enhancement in septum with nodule cases and two different previously enhancement in thick septum cases, so did CEUS. The degree of enhancement correlated well positively with the dynamic SCT and CEUS in 18 cases of MCRCC(P ＜0.05). Conclusion The typical imaging features of MCRCC are multilocular cystic masses composed of serous fluid with regular thin cystic wall, thin coarse septum, thick septum and septum with nodule. There are enhancement from slight to moderate degree in septum cases by SCT and CEUS. The imaging features of SCT and CEUS are integrated in MCRCC, which may improve the accurate diagnosis of MCRCC and provide strong guidance for the clinical treatment.