肾癌的MR诊断、鉴别诊断及术前分期评估  

Renal Cell Carcinoma:MR Diagnosis,Differential Diagnosis and the Evaluation of Staging Preoperation

作　　者：赵力[1] 苗延巍[1] 郎志谨[1] 

机构地区：[1]大连医科大学附属第一医院放射科,116011

出　　处：《实用放射学杂志》1999年第11期663-666,共4页Journal of Practical Radiology

摘　　要：目的：探讨ＭＲ对肾癌诊断、鉴别诊断和术前分期的价值。方法：使用美国ＧＥ公司生产Ｓｉｇｎａ １．５ＴＭＲ机，对３４例肾癌病人进行检查，男２３例，女１１例，全部经手术病理组织学检查证实。结果：肾癌的ＭＲＩ表现为肾轮廓异常，ＣＭＤ消失，信号异常多样化，Ｔ１ 加权低信号１２例，等信号１２ 例，高信号５例，混合信号５ 例，Ｔ２ 加权低信号７ 例，等信号３例，高信号１４例，混合信号１０ 例。假包膜形成，Ｔ１ 显示５ 例，１４％ ，Ｔ２ 显示１３ 例，占３８％ 。造影有轻微增强。一期肾癌７例，分期诊断正确６ 例，二期肾癌１７ 例，分期诊断正确１２例，三期肾癌５例，分期诊断全部正确，四期肾癌５例，４例分期诊断正确。结论：肾癌的ＭＲ表现有特征性，对鉴别诊断有价值，Ⅰ、Ⅱ期肾癌区分有一定困难，Ⅲ、Ⅳ期肾癌的诊断正确率高，全组分期诊断正确为７９．４％ 。Objective:To assess MR diagnosis,differential diagnosis and the value of staging preoperation of renal cell carcinoma.Methods:Thirty-four patients of renal cell carcinoma proved surgically and pathologically were imaged with MRI.There were 23 males,11 females.Results:MR findings of renal cell carcinoma were as follows:the abnormolity of renal outline,disappearance of CMD the signal intensity of lesions including high signal(n=5),equal signal(n=12),low signal(n=12)and mixed signal intensity (n=5)on T 1WI,high signal(n=14),eqaul signal(n=3),low signal(n=7)and mixed signal intensity(n=10)on T 2WI.The pseudocapsule were showed on T 1WI in 5 case(14%),on T 2WI in 13 cases(38%).The lesions were slightly enhanced on contrast enhanced scans.In the staging study,stageⅠ,Ⅱ,Ⅲ and Ⅳ were 1,17,5 and 5 respectively,of which were correctey diagnosed in stage Ⅰ,Ⅱ,Ⅲ and Ⅳ were 6,12,5 and 4 respectioely.Conclusion:Renal cell carcinoma is of characteric MR findings which are of value in differential diagnosis.To distinguish the stage Ⅰ and Ⅱof RCC has a little difficult,but to distinguish the stage Ⅲ and Ⅳ of RCC is easy.The diagnostic ratio of all groups together is 79.4.

关 键 词：肾细胞瘤 分期 成像 NMR 诊断 鉴别诊断 

分 类 号：R737.110.4[医药卫生—肿瘤] R730.44[医药卫生—临床医学]