多层螺旋CT多期增强扫描在小肾癌诊断中的应用价值

目的探讨多层螺旋CT（MSCT）多期增强扫描在小肾癌诊断和鉴别诊断中的价值。方法回顾性分析32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32例患者中平扫病灶等密度6例，低密度19例，稍高密度5例，3例点状钙化。增强扫描皮质期20例明显强化，8例中度强化，4例轻度强化；均匀强化8例，不均匀强化24例。透明细胞癌25例，主要为不均匀明显强化；乳头状细胞癌3例，为轻度均匀强化；嫌色细胞癌及肉瘤样细胞癌各2例，为中度强化。32例患者中检出率100％，定性诊断正确率93．75％，分期正确率84．38％。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。

Application value of multiphasic MSCT in the diagnosis of small renal carcinoma

ObJective To evaluate the multi-slice spiral CT (MSCT) in the diagnosis of early small renal cell carcinoma (RCC). Methods 32 cases of small RCC proved by pathology were retrospectively analyzed. The relationship of imaging features MSCT with pathology was compared. Results Of the 32 RCC in this study, 19 patients were with low density, 6 medium density, and 5 minimal high density. In 24 patients, the lesion were seen as a mixed enhancement pattern, 8 were with the homogeneous enhancement pattern.In cortical phase, clear cell RCC (25/32) tended to be marked enhancement or mixed enhancement pattern; 2 chromophobe lesions and 2 angsarcomakoid renal cell carcinoma (2/32, 2/32 respectively) tended to enhance moderately, papillary lesions (3/32) were mostly hypovascular and homogeneous enhancement pattern. The detection and characterization as well as accuracy of staging in 32 small RCC on MSCT were 100%, 93.75%, and 84.38%, respectively. Conclusion Muhiphase enhanced MSCT scan was a reliable technique in the dectection and clinical predicting subtype of small RCC.