肾透明细胞癌与肾乳头状癌CT、MRI表现的比较

目的探讨肾透明细胞癌与肾乳头状癌的CT、MRI表现差别。方法选择2001年2月～2010年12月我院收入的肾透明细胞癌与肾乳头状癌患者共98例，其中肾透明细胞癌75例，乳头状肾细胞癌23例，对两组患者行CT、MRI扫描。对比两组患者的影像学差别。结果两组患者各扫描期CT值对比显示，乳头状肾细胞癌组平扫CT显著高于肾透明细胞癌组，两组差异有统计学意义（P〈0．05）。肾透明细胞癌组皮髓期、实质期以及排泄期CT值显著高于乳头状肾细胞癌，两组差异有统计学意义（P〈0．05）。两组患者增强相对强度对比中显示，肾透明细胞癌组皮髓期、实质期以及排泄期增强相对强度对比与乳头状肾细胞癌对比差异有统计学意义（P〈0．05）。本组乳头状肾细胞癌MRI检查显示T1WI上病灶呈现低～中等信号，T2WI呈现等、低信号，MRI动态增强时肿瘤强化特征与CT增强相似。其中11例呈现均匀强化、5例呈现欠均匀强化、7例呈现不均匀强化。肾透明细胞癌中T1WI上病灶低信号，T2WI呈现高信号，多以边缘强化为主，全瘤均呈不均匀的强化。其中24例皮质期明显强化，轻中度强化46例。结论CT及MRI对鉴别肾透明细胞癌和乳头状肾细胞癌均有一定的参考价值，其中肿瘤的增强程度是鉴别两者之间最有价值的参数。

Renal clear cell carcinoma and renal papillary carcinoma CT,MRI control study

Objective To investigate the renal clear cell carcinoma and renal papillary carcinoma of the CT,MRI performance difference.Methods This selected group from Feb 2001 to Dec 2010 in our hospital in revenue of renal clear cell carcinoma and renal papillary carcinoma in patients with a total of 98 cases,including 75 with clear cell carcinoma,papillary renal cell carcinoma 23 cases,in two groups of patients underwent CT,MRI scan,comparing the two groups of patients with radiologic differential.Results The two groups of patients with various scanning period CT contrast display,papillary renal cell carcinoma was significantly higher than that in group CT scan in clear cell renal cell carcinoma group,two groups of contrast the differences were statistically significant(P < 0.05).Clear cell renal cell carcinoma group skin pulp stage,parenchymal phase and excretory phase CT values were significantly higher than that of papillary renal cell carcinoma,two groups of contrast the differences were statistically significant(P < 0.05).In two groups of patients with enhanced relative intensity contrast in display,clear cell renal cell carcinoma group skin pulp stage,parenchymal phase and excretory phase enhanced relative intensity contrast with papillary renal cell carcinoma and compared the difference was statistically significant(P < 0.05).This group of papillary renal cell carcinoma MRI showed T1WI lesions showed low to medium signal,T2WI appears to low signal,MRI dynamic enhancement tumor enhancement features and enhanced CT similarity.Among the 11 patients showed homogeneous enhancement,5 patients presented with less homogeneous enhancement,7 cases showed heterogeneous enhancement.Clear cell renal cell carcinoma in T1WI lesions of low signal,T2WI showed high signal,the more the edge enhancement,the tumor showed inhomogeneous enhancement.Among 24 patients with cortical phase enhanced obviously,mild to moderate enhancement in 46 cases.Conclusion CT and MRI in differential diagnosis of clear cell renal cell carcinoma and papillary renal cell carcinoma has a certain reference value,in which the tumor enhancement degree is the differential between the two most valuable parameter.