肾脏偶发癌的影像学诊断  

The imaging diagnosis of incident renal carcinoma

作　　者：于学林[1] 崔进国[1] 王晓琪[2] 祝玉芬 刘皎然[4] 田庆波[4] 任红[5] 

机构地区：[1]白求恩国际和平医院放射诊断科,050082 [2]白求恩国际和平医院CT室 [3]白求恩国际和平医院磁共振室 [4]白求恩国际和平医院超声诊断科 [5]河北省企业家体检基地

出　　处：《中国CT和MRI杂志》2006年第1期23-26,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨肾脏偶发癌(incidentrenalcarcinoma,IRCC)的影像学表现。方法对1996～2004年间我院54例经手术病理证实的肾脏偶发癌影像学资料进行回顾分析。B超检查52例,其中20例同时行彩色多普勒血流成像(CDFI),CT检查45例,MRI及DSA检查各6例。结果在B超检查组中,32例(61.5%)肿物表现为低回声,19例(36.5%)肿物表现为强回声,29例(78.4%)肿物周缘显示低或高回声光晕,彩超检查显示10例(50%)肿物内有丰富血供,9例(36.5%)血流增加并呈动脉频谱RI10.49～0.73,超声正确诊断率82.7%。在CT检查组中,45例均行平扫和强化扫描,11例(24.4%)平扫显示肿物内含钙化成分,1例(2.2%)平扫显示肿物内含假性囊肿,42例(93.3%)肿物低于肾实质强化,2例(4.4%)肿物周缘分别显示弧形低密度影和环形等密度影,2例(4.4%)肿物周缘显示增生血管围绕,CT正确诊断率93.3%。在MRI检查组中,1例(16.7%)T1WI肿物周缘显示低信号环,5例(83.3%)T2WI肿物周缘显示低信号环,MRI正确诊断率100%。在DSA检查组中,4例(66.7%)在动脉期显示肿瘤内血管增多、周缘血管呈“抱球”状环绕,1例(16.7%)周缘显示透明晕,5例在实质期显影时间延长,染色不均匀,DSA正确诊断率83.3%。结论综合应用影像学检查对IRCC的早期诊治有重要意义。Objective To explore characteristics of incident renal carcinoma （IRCC）on imaging. Methods 54 patients with IRCC admitted during 1996-2004 and proved by surgical pathology examination were retrospectively studied with their data of imaging. 52 patients were examined with B ultrasound, among whom 20 being concomitantly examined with Color Doppler flow imaging（CDFI）; 45 were examined with CT, 6 were examined with MRI, and 6 with DSA. Results In the B-US group, 32 patients （61.5%） showed hypoechoic mass, 19（36.5%）showed hyperechoic mass, 29 （78.4%） manifested hypoechoic or hyperechoic rims around the masses. Of those who underwent CDFI, 10 （50%）showed abundant blood-supply to tumors, 9 （36.5%） showed accelerated artery flow and spectrum RI 10.49-0.73. Diagnostic accuracy rate of B-US was 82.7%. In the CT group, 45 patients underwent plain scan and contrast-enhanced scan. 11 （24.4%）showed calcification inside the mass on plain scan, 1 （2.2%） showed pseudocyst inside the mass on plain scan, 42（93.3%）showed that the renal masses were enhanced inferior to normal renal parenchyma, 2 （4.4%） showed rim-like hypointensity or ringlike isointensity around the masses, 2（4.4%）showed hyperplasic blood vessels around the masses. The accuracy rate of CT group was 93.3%. In the MRI group, 1（16.7%） showed hypointensity ring around the mass on T1WI, 5 （83.3%）showed hypointensity ring around the mass on T2WI. The accuracy rate of MRI was 100%. In the DSA group, 4 （66.7%）, on arterial phase, showed hyperplasic blood vessels, clawing the masses, 1 （16.7%）showed transparent halo, 5 （83.5%）, on parenchymal phase, showed elongated developing time and inhomogeneous stain. The accuracy rate was 83.3%. Conclusion A comprehensive manipulation of imaging techniques is helpful for early diagnosis of IRCC.

关 键 词：肾脏偶发癌 B超 彩色多普勒 血流成像 体层摄影术  X线计算机 磁共振成像数字减影血管造影 

分 类 号：R445.1[医药卫生—影像医学与核医学] R445.2[医药卫生—诊断学]