磁共振成像对肾癌分期的价值  

MRI staging of renal cell carcinoma

作　　者：王霄英[1] 范诒忠 梁妍[3] 谢晟[1] 孙晓伟[1] 蒋学祥[1] 

机构地区：[1]北京大学第一医院医学影像科,北京100034 [2]河北省清河县第二医院MR室 [3]吉林省长春市人民医院放射科

出　　处：《中国医学影像技术》2004年第11期1717-1720,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的　评价磁共振成像对肾癌分期的诊断价值。方法　 49例经手术病理证实的肾癌患者 ,术前行MR检查 ,并根据影像表现分期。术后根据手术病理结果 ,用Robson分期法将其分为Ⅰ～Ⅳ期 ,将MR分期与术后病理分期进行对照研究。结果　 49例患者术后病理分期 :Ⅰ期 12例 ,Ⅱ期 10例 ,Ⅲ期 2 0例 ,Ⅳ期 7例。MR诊断正确率为Ⅰ期 75 % ( 9/12 )例 ,Ⅱ期 70 % ( 7/10 ) ,Ⅲ期 85 % ( 17/2 0 ) ,Ⅳ期 10 0 % ( 7/7) ,总的诊断正确率为 81.6% ( 4 0 /4 9)。MR对Ⅰ期患者分期错误的主要原因是病灶较小 ,在图像上有部分容积效应而显示边界不清楚 ;对Ⅱ期患者是病灶周围有微小的肾周浸润 ,在MR图像上未能显示 ;对Ⅲ期患者的主要原因是肾静脉内的微瘤栓在MR图像不能显示。结论　MR可用于肾癌的分期 ,对于Ⅲ、Ⅳ期肾癌的分期诊断准确性较高 ,而对于Ⅰ。Objective To evaluate the significance of magnetic resonance imaging in the staging of renal cell carcinoma. Methods Forty-nine patients with pathologically proved renal cell carcinoma were examined with MR before operation. The patients were staged according to MR findings. The results were compared with the pathological records. Results The pathological staging results of the 49 RCCs according to Robson criteria were as following: stage Ⅰ 12 cases, stage Ⅱ 10 cases, stage Ⅲ 20 cases, and stage Ⅳ 7 cases. The accuracy rate of MR was 75% (9/12) for stage Ⅰ RCCs, 70% (7/10) for stage Ⅱ, 85% (17/20) for stage Ⅲ, and 100% (7/7) for stage Ⅳ RCCs, respectively, and the total accuracy rate of MR was 81.6% (40/49). Partial volume effect led to unclearly defined border of small size tumors, and thus resulted over-staging in 3 stage Ⅰ cases. In 3 cases of stage Ⅱ RCCs, tiny invasion of the peripheral structures of the kidney were detected under microscope, but not found with MRI, leading to under-staging of the tumors. Micro-thrombus in the renal vein missed by MRI caused under- staging in 3 cases of stage Ⅲ RCCs. Conclusion MR is useful in the staging of renal cell carcinoma. The accuracy rate is higher in advanced tumors than in the early stage tumors. [

关 键 词：磁共振成像 肾癌 分期 

分 类 号：R737.11[医药卫生—肿瘤] R445.2[医药卫生—临床医学]