肾细胞癌的螺旋CT表现及与病理间的关系

目的　探讨肾细胞癌(RCC)的螺旋CT(SCT)表现及与病理间的关系。资料与方法　搜集行SCT检查并经手术病理证实的RCC 34例,将SCT征象分组与病理征象进行比较。结果　(1) 34例RCC增强后均有显著强化,其中2 6例肿瘤在皮髓期密度等于或超过肾皮质,8例低于肾皮质高于肾髓质;SCT双期增强扫描对34例RCC的检出率为10 0 % ,定性诊断率为10 0 % ,分期的准确性为94 %。(2 )SCT上肿瘤边缘清晰者14例,病理检查12例有完整的假包膜(85 .7% ) ;细胞核分级在瘤体直径>3.0cm组、肿瘤边缘不清晰组、瘤体中心有坏死不强化区组,分别高于瘤体直径≤3.0cm组、肿瘤边缘清晰组、瘤体内无坏死区组(P均<0 .0 1)。结论　SCT双期增强扫描是RCC可靠的检查方法,能准确反映其病理学基础。

Study on the Correlation Between SCT Features and Pathology in Renal Cell Carcinoma

Objective To evaluate the correlation between spiral CT (SCT) features and pathology in renal cell carcinoma (RCC).Materials and Methods 34 patients with RCC diagnosed by pathology were retrospectively analyzed to compare the SCT and pathological results.Results (1)34 RCCs were demonstrated as remarkable enhancement, 26 of the 34 tumors were hyperdense or isodense to the cortex in corticomedullary phase, 8 tumors were hypodense to cortex but were hyperdense to medulla. The detection and characterization as well as accuracy of staging of 34 RCC of two phase enhanced SCT scans were 100%, 100% and 94% respectively. (2)14 tumors with clear margin on SCT scans mostly had 12 pseudocapsules at pathological examination. The nuclear grade was higher in groups of tumor having blurred margin, central necrosis, diameter larger than 3.0cm than those of tumors having clear margin, without central necrosis, diameter less than 3.0cm (P<0.01, P<0.01, P<0.01, respectively).Conclusion Dualphase enhanced SCT scan is a reliable technique in the detection, characterization and staging of RCC.