多层螺旋CT多期扫描在小肾癌诊断中的价值

目的分析多层螺旋CT（SCT）多期扫描在小肾癌诊断中的价值。方法选取确诊为小肾癌的患者124例,年龄41~75岁,平均（58.1±8.4）岁。分析患者术前肾脏SCT资料,比较不同病理亚型瘤体密度、各期CT值、强化程度和模式。结果平扫期,嫌色细胞癌瘤体密度均匀,乳头状癌和透明细胞癌瘤体密度不均匀。透明细胞癌皮髓期呈不均匀强化,实质期强化程度快速下降,排泄期持续下降;乳头状和嫌色细胞癌皮髓期呈轻度或中度均匀强化,实质期和排泄期呈持续强化。乳头状癌平扫期CT值显著高于透明细胞癌和嫌色细胞癌（P〈0.05）,嫌色细胞癌和乳头状癌排泄期、实质期和皮髓期CT值均显著低于透明细胞癌（P〈0.05）,透明细胞癌和乳头状癌均匀强化的比率显著低于嫌色细胞癌（P〈0.05）。结论 SCT多期扫描是诊断小肾癌较理想的选择之一,其不同病理亚型具有特征性SCT表现。

The value of multi-phase SCT in diagnosing small renal cell carcinoma

Objective To analyze the value of multi-phase spiral CT (SCT) scan in diagnosing small renal cell carcinoma (RCC). Methods One hundred and twenty-four patients aged from 41 to 75 years old, average of (58.1±8.4) years with small RCC were selected. The SCT results of all patients were analyzed. The tumor density, CT values, strengthen the extent and pattern of different subtypes were compared. Results On unenhanced phase (UP), clear cell carcinoma (CCC) showed inhomogeneous density, papillary RCC (PRCC) and chromophobe RCC (CRCC) showed homogeneous density. CCC were inhomogeneous enhanced on corticomedullary phase (CMP), during parenchymal phase (NP) and excretory phase (EP), the contrast materials were washed out quickly. PRCC and CRCC were slightly or moderately enhanced on CMP, during NP and EP, they showed persistent enhancement. On UP, CT attenuation value of PRCC was higher than those of CRCC and CCC (P < 0.05). On CMP, NP and EP, CT value of CCC was higher than those of CRCC and PRCC (P < 0.05). In CRCC, the rate of homogeneous enhancement was higher than those in PRCC and CCC. Conclusion SCT multiphase scanning is the ideal choice for the diagnosis of small renal cell carcinoma, its different pathological subtypes have characteristic SCT performance.