肾细胞癌分期与复发的CT诊断

目的 探讨CT对肾癌病人术前分期与术后复发的诊断价值.方法 分析18例经手术病理证实肾细胞癌病人在手术前后的CT表现.右肾10例,左肾8例,术后7例行CT复查,复查时间3个月至1年半,CT发现3例病人有不同形式的复发与转移.使用GE Lightspeed Plus型CT机,全部病例行平扫与增强检查.结果 CT显示肿块位于肾包膜内3例,突破肾包膜并侵及肾筋膜12例,肿块突破肾周筋膜并肾静脉或下腔静脉瘤栓3例,其中1例侵及同侧肾上腺.未突破肾包膜的3例中CT表现与术中所见一致.12例CT显示肾周侵犯者中4例手术中和病理下未见肾周侵犯,为假阳性(4/12,33.3%),病理显示未受侵犯的肾周筋膜呈水肿伴炎性细胞浸润改变.在CT显示肿块突破肾周筋膜产有肾静脉或下腔静脉内瘤栓的3例中,手术所见与病理结果一致,准确性达100%.结论 CT检查可准确描绘原发肿瘤的大小,但对判断原发肿瘤有否突破肾被膜,肾周脂肪与肾筋膜是否受侵犯方面有一定限度,假阳性较假阴性率高.CT对肾细胞癌腹膜后淋巴结转移的假阴性率较高.

CT diagnosis for staging and recurrence of renal cell carcinoma

Objective To study the CT diagnosis value for staging and recurrence of renal cell carcinoma. Methods Analysis CT manifestation of renal cell carcinoma eighteen cases, while before and after operation treatment. Tumor on right side ten cases, left side eight cases. After operation have seven cases examination by CT, while from three to eighteen months, amongst funding recurrence and metastasis three cases by CT examination GE Lightspeed Plus CT be used. All of patients by plain and enhancement examination. Results The renal cell carcinoma within a membrane of the kidney three cases, that pass through the membrane twelve cases. Three cases renal cell carcinoma with thrombosis of renal vein or inferior cavity vein. Three cases tumors within the membrane the CT manifestation uniform operation fund, tumor pass through the membrane of the kidney have twelve cases on CT fund, amongst only eight cases uniform operation and pathological examination, which false positive rate 33.3%, three cases have thrombosis of tumor in renal vein or inferior cavity vein by CT ex- amination uniform operation fund, accuracy was 100%. Conclusions CT exanfination have high accuracy for size of renal cell carcinoma, which limit on diagnosed whether or not pass through renal membrane, which false positive more than false negtive. CT examination for lymphnode metastasis of renal cell carcinoma have high false negtive rate.