囊性肾细胞癌的动态增强CT表现

目的：探讨单房囊性和多房囊性肾细胞癌的动态增强CT表现特征，以提高其诊断准确性。方法：经手术病理证实的8例囊性肾透明细胞癌术前均行螺旋CT平扫及增强皮髓交界期、实质期、排泄期扫描；分析每一肿瘤的囊壁、囊内间隔、壁及隔结节的平扫，尤为动态增强CT表现。结果：8例囊性肾透明细胞癌中，多房囊性者6例，单房囊性者2例。CT平扫所有肿瘤均表现为肾实质内圆形或分叶状低密度囊性病变。部分病灶突向肾轮廓外：囊内密度不均7例；5例可见囊壁和／或内隔，其中囊壁不规则增厚和，或有结节者3例，3例伴有囊壁和，或内隔钙化。多期动态增强检查，与平扫相比囊壁、内隔、结节显示更为清楚；7例显示囊壁、内隔、壁结节发生不同形式的强化，其中，4例呈快进快退型强化，3例呈轻至高度进行性延迟强化；1例因囊壁钙化，有无强化分辨不清。结论：囊性肾细胞癌的CT动态增强表现具有一定特征，有助于正确诊断，但表现不典型者，还需与其他肾脏良性囊性疾病相鉴别。

Dyllainic SCT diagnosis findings on cystic renal cell carcinoma

Objective： To explore the dynamic enhancement features of unilocular and multilocular cystic renal cell carcinoma and evaluate its clinical value. Methods： Eight cases with unilocular and multilocular cystic renal cell carcinoma confirmed by surgical pathology underwent spiral CT plain scanning and dynamic enhancement scanning including corticomedullary, parenchymal and renal pelvis phase before operation. The radiologic findings were evaluated for cystic wall, septum and nodularity of each cysts. Results： There were 2 unilocular and 6 multilocular cystic renal cell carcinoma appeared as round or lobulated masses which projected over the contour of renal cortex. 7 cysts were composed of inhomogeneous serous fluid, cystic wall was irregular thick with or without nodularity in 3 cases, 3 cases had calcification in cystic wall and/or septum. Cystic wall, septum and nodularity showed all the more clear in dynamic enhancement scanning than plain CT scanning with different degree enhancement. 4 cases showed obviously enhancement in corticomedullary phase which were regressive quickly in the parenchymal phase and pyelographic phase. For another 3 cases, the enhancement were slight to marked delayed enhancement, the enhancement could not be discriminated in l CRCC because of calcification in a wall. Conclusion： The dynamic enhancement findings of CRCC have their own characteristics. We could get definite diagnosis with that typical features, but we must differentiate atypical CRCC from benign cystic lesions.