肾脏集合管癌的CT诊断  

CT imaging of collecting duct carcinoma of the kidney

作　　者：庞涛[1] 刘群[2] 马祥兴[3] 王新怡[1] 董杰[1] 李爱银[1] 

机构地区：[1]山东省千佛山医院放射科,济南250014 [2]山东省千佛山医院病理科,济南250014 [3]山东大学附属齐鲁医院CT室

出　　处：《中华放射学杂志》2004年第10期1094-1098,共5页Chinese Journal of Radiology

摘　　要：目的　提高对肾脏集合管癌CT表现的认识。方法　报告 3例经病理证实的肾脏集合管癌的螺旋CT所见 ,并作文献复习。结果　男 2例 ,女 1例 ,肿瘤位于右肾者 2例 ,左肾 1例。位于右肾的 1例 ,肿瘤累及肾皮质和髓质 ,并突出于肾轮廓之外 ,大小约 8 0cm× 8 0cm ,平扫CT值约37～ 4 5HU ,其内见高密度的斑点状钙化灶。增强动脉期 (皮质期 )及静脉期 (髓质期 )扫描示病变呈不均匀性强化 ,无包膜 ,CT值约 5 2～ 10 7HU ,CT诊断为右肾癌 ,但不排除肾结核。另外 2例肿瘤同时累及肾皮质、髓质及肾盂 ,其中位于左肾的 1例 ,肿瘤大小约 7 0cm× 7 5cm ,平扫病变区CT值约2 2HU ,增强动脉期 (皮质期 )扫描示肾皮、髓分界不清 ,病变区CT值约 70HU ,静脉期 (髓质期 )示肾静脉内癌栓形成 ,排泄期 (肾盂期 )扫描示左肾盂、肾盏未见显影 ,CT诊断为左肾癌 (集合管癌可能性大 )。另外 1例位于右肾 ,肿瘤大小约 8 0cm× 14 0cm ,平扫CT值约 32HU ,增强动脉期 (皮质期 )及静脉期 (髓质期 )扫描示肿瘤与正常的肾组织无明显分界 ,CT值约 4 5～ 72HU ,排泄期 (肾盂期 )扫描示左肾盂、肾盏未见显影 ,CT诊断为右肾癌 ,但不排除肾结核。 3例中 2例可见肾周脂肪囊及肾筋膜受侵犯 ,2例有局部淋巴结转移 ,1例有肋骨转移。Objective To enhance the understanding of CT appearance in collecting duct carcinoma of the kidney. Methods The CT features in 3 cases of collecting duct carcinoma of the kidney confirmed by pathology were reported, and the literature was reviewed. Results 3 patients comprised 2 males and 1 female. 2 tumors located in the right kidney, 1 tumor located in the left kidney. Medulla and cortex were involved in 1 of the 3 cases. The tumor was about 8.0 cm×8.0 cm. It was bulgy from outline of the kidney. The CT value was about 37～45 HU on plain CT scan, and there was high-density calcification in it. It showed inhomogeneous enhancement in arterial and venous phase after the injection of contrast material, and the CT value was about 52～107 HU. No capsule could be seen. The CT diagnosis was carcinoma of right kidney, but tuberculosis was not excluded. Medulla, cortex, and pelvis were all involved in another 2 cases. One tumor was about 7.0×7.5 cm and it was in the left kidney. The CT value was about 22 HU on plain CT scan. The interface between cortex and medulla was blurry in arterial phase after the injection of contrast material, and the CT value was about 70 HU. The embolism could be seen in the renal vein in venous phase. The pelvis was not displayed in excretory phase. The CT diagnosis was carcinoma of left kidney (probably collecting duct carcinoma). The other tumor located in the right kidney, it was about 8.0 cm×14.0 cm, The CT value was about 32 HU on plain CT scan. The interface between cortex and medulla was also blurry in arterial and venous phase after the injection of contrast material, and the CT value was about 45-72 HU. The pelvis was not displayed in excretory phase. The CT diagnosis was carcinoma of right kidney, but tuberculosis was not excluded. Infiltration of perirenal fat and fascia was present in 2 of the (3 cases.) Metastasis was present in focal lymph nodes in 2 cases, and metastasis was present in a costa in (1 case.) Conclusion CT is a valuable tool in the diagnosis of collecting

关 键 词：肿瘤 CT值 右肾 肾脏集合管癌 CT诊断 动脉期 平扫 扫描 斑点 轮廓 

分 类 号：R737.11[医药卫生—肿瘤]