肾脏囊实性小占位病变多排CT与高强场MRI的诊断价值  

Multidetector CT and high magnetic field MRI in evaluation of small cystic-solid renal mass

作　　者：赵炳辉[1] 李明华[1] 周康荣 

机构地区：[1]上海交通大学第六人民医院放射科,上海200233 [2]上海市影像研究所,上海200032

出　　处：《上海交通大学学报（医学版）》2008年第1期25-28,共4页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的探讨多排CT与高强场磁共振(MRI)对肾脏囊实性小占位病变的诊断价值。方法连续收集肾内囊实性小占位病变(≤3 cm)52例,包括透明细胞型肾癌24例,乳头型肾细胞癌1例,类癌1例,血管平滑肌脂肪瘤7例,复杂囊肿16例,囊性肾瘤3例,均经1.5TMRI和多排CT检查,两者间隔时间3 d至2个月。结果所有病例均经手术病理证实。多层面重建技术能明显提高多排CT对肾内小占位病变的检出敏感度(98.1%),与MRI检出敏感度近似;但多排CT对肾脏囊实性小占位病变的诊断准确度为71.2%,明显低于MRI检查(90.4%)(P=0.001)。MRI多序列扫描有助于病变组织内出血、坏死及肿瘤实质等成分的识别,且对小肾癌假包膜的检出率较高(57.7%)。结论高强场MRI对肾脏囊实性小占位病变的定性诊断具有较高价值,CT检查不能明确诊断时,MRI是较为有效的无创影像学检查手段。Objective To evaluate the role of multideteetor CT （MDCT） and high magnetic field MRI in diagnosis of small cystic-solid renal mass. Methods Fifty-two cases with small renal cystic-solid mass （ ≤3 cm） were consecutively collected, including small cystic-solid renal cell carcinoma （ n = 25） , carcinoid （ n = 1 ） , complex cysts （ n = 16） , small angiomyolipoma （ n = 7） and benign cystic nephroma （ n = 3）. All were examined by both 1.5T MRI and multidetector CT at intervals between 3 days and 2 months. Results All cases were proved by pathology. Multi-planar reconstruction techniques were useful for MDCT in differentiating small cystic-solid renal mass, with the sensitivity of 98.1% , which was as high as MRI. However, the accuracy for MDCT was 71.2% , significantly lower than that of MRI （90.4%） （P = 0. 001 ）. MRI helped to identify the components and structure of renal masses, and behaved better in the detection of pseudo-capsule of renal cell carcinoma（57.7% ）. Conclusion High magnetic field MRI may play an important role in the diagnosis of small renal cystic-solid masses, and it may be feasible as a noninvasive examination when CT can not make the ultimate determination.

关 键 词：肾脏小占位 囊实性 磁共振成像 多排CT 

分 类 号：R445[医药卫生—影像医学与核医学] R737.1[医药卫生—诊断学]