动态增强CT扫描对肾嫌色细胞癌的诊断价值分析

目的 探讨动态增强CT扫描对肾嫌色细胞癌的诊断价值及其临床应用. 方法回顾性分析12例经手术和病理证实为肾嫌色细胞癌的动态增强CT影像资料,对肿瘤的大小、形态、密度及动态增强特点进行分析. 结果 12例病例动态增强CT表现,原发病灶均为单发,呈软组织密度,3例见假包膜,5例有分叶,肿瘤密度均匀5例,不均匀7例,内部可见线状、小片状坏死或星芒状纤维灶,坏死区一般较小,边缘光整,1例见钙化,动态增强扫描皮髓期肿瘤强化明显低于肾皮质,而高于肾髓质,实质期强化明显低于肾实质,瘤体≤7 cm×6.5 cm的均未见转移. 结论肾嫌色细胞癌属膨胀性生长、少血供、低度恶性肿瘤,其恶性程度与肿瘤大小和坏死程度有关,其动态增强CT表现具有一定特征性,动态增强CT扫描对肾嫌色细胞癌的发现、术前临床评估和指导治疗有着重要的价值.

Value of dynamic enhanced CT scan in diagnosing chromophobe cell renal carcinoma

Objective To evaluate the value and clinical application of the dynamic enhanced CT scan in diagnosing chromophobe renal cell carcinoma （CRCC）. Methods The 12 patients with operation and pathology proven CRCC underwent plain and muhi-pahse contrast enhanced CT scan. Imaging findinds, including the tumor＇s size, shape, density and characteristic features on dynamic enhancement CT scan were analyzed retrospectively. Results In 12 cases, all primary tumors were solitary and homogeneous. Pseudocapsule was found in 3 cases and lobulated shape was found in 5 cases. The density of the tumor was homogeneous in 5 cases, uneven in 7 cases. There were linear, patch necrosis or stellate fibrous lesions in the interior of these 7 tumors. Necrosis area of tumors generally were small, and edge of tumors were smooth. Calcification was found in 1 case. All tumors were hyperdense compared with renal medulla, but the density was lower than renal cortex in the corticomedullary phase of dynamic enhanced CT scan. All tumors became hypodense compared with renal parencbyma on the parenchymal phase scan. Metastasis was not found in tumors which were equal or lesser than 7 cmx6.5 cm. Conclusion CRCC is a expansive growth, less blood supply, low potential malignancy renal cell carcinoma, there are high correlation between the malignant degree and the tumor＇s size or the degree of necrosis. The dynamic enhancement CT characters of CCRC have special features, which is important for diagnosis and treatment of CRCC.