囊性肾癌的CT诊断和鉴别诊断

目的:探讨囊性肾癌的CT表现特点,旨在提高诊断及鉴别诊断水平。方法:回顾性分析14例经手术病理证实的囊性肾癌CT影像学表现特点。结果:囊性肾癌14例中,单囊8例、多囊6例。囊壁增厚或厚薄不均11例,囊壁菲薄均匀3例。其中伴壁结节及分隔各4例、伴壁结节与分隔同时存在2例,分隔厚薄不均5例、纤细均匀1例。平扫肿瘤呈囊实性混杂密度12例、呈较均匀囊样低密度2例;囊液密度较高、隐约见碎屑、絮状物或明显出血9例,囊液均匀如水5例;肿瘤实性部分钙化3例。增强后肿瘤实性部分呈明显快进快退型强化11例,部分呈快进快退型强化合并部分中度进行性延迟强化1例,轻度强化2例。肾门或后腹膜淋巴结转移4例。结论:CT检查对囊性肾癌的诊断和鉴别诊断具有一定的临床实用价值。

CT Diagnosis and Differential Diagnosis of Cystic Renal Cell Carcinoma

Objective:To study the CT image features of cystic renal cell carcinoma (CRCC),for the purpose of improving the level of diagnosis and differential diagnosis.Methods:CT imaging features of 14 cases of CRCC confirmed surgically and pathologically were analyzed retrospectively.Results:In 14 cases of CRCC,there were 8 cases of single-cystic and 6 cases of multi-cystic.The cystic wall was thickened and uneven in 11 cases,and even in 3 cases.There were mural nodule and septation in 4 cases each.In 2 cases there was coexistence of mural nodule and septation.The septation was uneven in 5 cases and fine and even in 1 case.On plain scanning cystic solid tumor of mixed density was found in 12 cases,cystic relatively homogeneous low-density in 2 cases,cystic liquid of high density with faint debris and floc and obvious bleeding in 9 cases,cystic liquid homogeneous as water in 5 cases,calcified solid part of tumor in 3 cases.After CT enhancement,the solid part of tumors was significantly enhanced with rapid-in and rapid-out type in 11 cases,and part of the tumor showed rapid-in and rapid-out type enhancement with woderate progressive delayed enhancement in one case.Renal hilum or retroperitoneal lymph gland metastasis was found in 4 cases.Conclusion:CT scanning plays important roles in the diagnosis and differential diagnosis of CRCC.