多层螺旋CT多期增强扫描在小肾癌诊断中的临床价值  

Clinical value of multislice helical CT multi-phase scan on the diagnosis of small renal cell carcinoma

作　　者：黄崇权[1] 张丽敏[1] 斯洋[1] 徐立文[1] 郑文龙[1] 洪瑞镇[1] 

机构地区：[1]浙江省温州市第二人民医院放射科,浙江温州325000

出　　处：《医学影像学杂志》2008年第7期776-779,共4页Journal of Medical Imaging

摘　　要：目的:评价多层螺旋CT多期增强扫描在小肾癌诊断中的临床价值。方法:回顾性分析17例经手术病理证实的小肾癌的螺旋CT表现。结果:17例中小实性肾癌15例,小囊性肾癌2例;CT平扫呈低密度12例,等密度4例,稍高密度1例,伴有斑点状钙化2例;增强扫描皮质期13例呈不均匀明显强化,2例呈轻中度强化,另2例小囊性肾癌的囊壁、壁结节及囊内分隔明显强化;实质期、肾盂期扫描所有肿瘤强化均迅速减退,呈"快进快退"改变;4例可见假包膜。17例MPR/MIP9、例VR重建均能清楚显示肾血管、肿瘤与邻近组织的关系,并发现副肾动脉2例。结论:小肾癌多为富血供肿瘤,多层螺旋CT多期扫描能提高小肾癌的检出能力及定性诊断率;MPR/MIP、VR重建能清楚显示肿瘤及肿瘤与邻近组织、器官的关系,发现肿瘤肾的肾动脉有无先天变异、静脉内有无癌栓,能为外科手术提供所需要的关键信息。Objective：To evaluate the effect of multislice helical CT multi-phase scan on the diagnosis of small renal cell carcinoma（RCC）.Methods：The CT features of 17 RCC confirmed by pathology were retrospectively analyzed.Results：15 cases were small solid RCC,2 cases small cystic RCC.By non-enhancement scan,12 cases showed low density mass,4 cases equal density mass,1 case slightly high density mass,and 2 cases stippled calcification mass.By enhancement scan,13 cases showed inhomogenous enhancement in cortical phase,2 cases showed slight to moderate enhancement.Another 2 cases of small cystic RCC presented enhancement of wall with nodules and the partition.The enhancement of all tumor cases faded away in the following parenchymal phase and pyelographic phase,demonstrating some degrees of ＂fast washing out＂ phenomenon;4 cases presented with pseudocapsule.The reconstruction of 17 ＂MPR/MIP＂ and 9 ＂VR＂ showed clearly the relations of kidney vessels,tumors and neighbor tissues and accessory renal arteries were founded in 2 cases.Conclusion：Mest RCC are the tumors with rich blood supply,which can could be detected in qualitation by multislice helical CT multi-phase scan.The relations of kidney vessels,tumors and neighbor tissues can be showed clearly,and inborn variation of renal arteries in tumor kidney and the cancer epistom in vein can be also found.Therefore,the reconstruction of ＂MPR/MIP＂ and ＂VR＂,can provide the important information for surgery.

关 键 词：肾癌 体层摄影术 X线计算机 增强扫描 

分 类 号：R737.11[医药卫生—肿瘤] R814.42[医药卫生—临床医学]