肾细胞癌的螺旋CT诊断及超声的协同作用

目的研究肾癌的螺旋CT诊断，探讨超声的协同作用。资料与方法对可疑肾癌的病例进行前瞻性研究。结果74例共76个癌灶(2例为双肾肾癌)，CT增强扫描肿瘤明显强化50个，轻、中度强化25个，无强化1个。B超表现为低、等和高回声。41例行彩超检查，显示肾癌血供丰富23例，血流稀少14例，无血流信号4例。7例行超声血管造影，肿瘤均明显强化。结论螺旋CT能在术前对各类多血供肾癌作出正确诊断，但对少数轻度强化的肾癌特别是合并大量出血的肾癌诊断有困难，而超声往往能发挥特殊作用。

The Diagnosis of the Renal Carcinoma: The Spiral CT Cooperates with Ultrasound

Objective To evaluate the diagnosis of renal carcinoma by spiral CT and to explore the cooperative value of ultrasound.Materials and Methods A prospective study was made for suspicious renal carcinoma.Results Seventy six tumors were found in 74 patients, including bilateral renal carcinomas in 2 patients. After the administration of contrast media, 50 tumors were enhanced remarkably; 25 tumors were shown as mild to moderate enhancement, and the other one was demonstrated no enhancement on CT scans. The tumors were depicted as hyperechoic, isoechoic and hypoechoic lesions on ultrasound. Forty one patients were examined by color Doppler ultrasound. Rich blood supply, poor blood supply and no blood supply were found in 23, 14 and 4 patients respectively. Contrast enhanced ultrasound were performed for 7 patients, and all of the tumors were enhanced greatly.Conclusion Renal carcinomas with rich blood supply can be diagnosed correctly by spiral CT. However, as for the renal carcinomas with mild enhancement, especially for those with severe hemorrhage in tumors, it is difficult for CT to make an accurate diagnosis, whereas sometimes ultrasound can play a special role.