多层螺旋CT多期增强扫描对小肾癌诊断价值的临床研究

目的探讨多层螺旋CT(MSCT)多期增强扫描在小肾癌诊断中的临床研究。方法回顾性分析21例经手术病理证实的小肾癌(≤3.0cm)术前MSCT多期扫描的影像特征,并与病理对照。结果 21例患者中平扫病灶高密度2例,等密度15例,低密度或略低密度4例,所有病例均未见钙化;增强扫描皮质期14例明显强化,高于正常肾皮质,6例中度强化,1例轻度强化,均匀强化5例,不均匀强化16例,21例患者中检出率为100%;手术及病理示,左肾12例,右肾9例,最大直径2.8cm,最小直径1.0cm;肾透明细胞癌10例,颗粒细胞癌5例,乳头状细胞癌2例,透明细胞与颗粒细胞混合癌2例,嫌色细胞癌1例,肉瘤样细胞癌1例;19例为单发病灶,1例为单侧2个病灶,1例为双侧各1个病灶;实性肿块17例,囊实性4例;有假包膜13例,无假包膜8例;病理分期:Ⅰ期10例,Ⅱ期9例,Ⅲ期2例。结论 MSCT多期增强扫描是小肾癌诊断及其亚型鉴别诊断的可靠检查方法。

Clinical Study of Multi-phase Enhanced Scan of Multi-slice Spiral CT(MSCT) for Diagnosis of Small Renal Cell Carcinoma

Objective To discuss the multi-phase enhanced scan of evaluate multi-slice spiral CT(MSCT) in the diagnosis of small renal cell carcinoma.Methods We retrospectively analyzed imaging features of multi-phase scan of MSCT in 21 cases with small renal cell carcinoma(≤3.0cm) who were confirmed by pathology of surgery.Results Two cases were plain lesions high-density,15 cases equal density and 4 cases low-density or slightly low-density in 21 patients.All cases showed no calcification.In enhanced scan cortex phase,14 cases were significantly enhanced which was higher than normal renal cortex,6 cases moderately enhanced,1 case mild enhanced,5 cases homogeneous enhanced,16 cases heterogeneous enhanced.The detection rate of the 21 patients was 100%.Surgery and pathology showed left kidney were in 12 cases and right kidney in 9 cases,with the maximum diameter of 2.8cm while minimum diameter of 1.0cm.Renal cell carcinoma was in 10 cases,5 cases with granular cell carcinoma,2 cases with papillary carcinoma and 2 cases mixed clear cell and granular cell carcinoma,2 cases with chromophobe cell carcinoma and 1 case with sarcoma-like cells carcinoma.There were 19 cases with single lesion,of which 1 case with unilateral 2 lesions,1 case with bilateral 1 lesion.Solid mass was in 17 cases,and cystic was in 4 cases.Pseudocapsule was in 13 cases.For pathological stage,Ⅰ stage had 10 cases,Ⅱstage 9 cases and Ⅲ stage 2 cases.Conclusion Multi-phase enhanced scan of MSCT is an effective method to diagnose small renal cell carcinoma and its subtypes.