肾细胞癌的CT影像特征与病理分型  

CT features and pathological typing of renal cell carcinoma

作　　者：温骞[1] 郝建成[2] 

机构地区：[1]皖南医学院附属弋矶山医院影像中心,241000 [2]安徽省芜湖市第一人民医院放射科

出　　处：《实用医学影像杂志》2014年第6期428-431,共4页Journal of Practical Medical Imaging

摘　　要：目的联合病理分型对肾细胞癌的CT影像特征进行分析以提高诊断的准确性。方法收集我院手术病理证实的47例肾细胞癌患者,术前均做CT平扫+动态增强扫描,回顾性分析CT影像特征并与病理结果对照分析。结果 34例透明细胞癌,5例多房囊性肾细胞癌,3例乳头状癌,4例嫌色细胞癌,1例集合管癌。最新病理分型将颗粒细胞癌和多房囊性肾细胞癌均归到透明细胞癌,此类型肾癌血供丰富,增强扫描后动脉期明显强化;而乳头状癌和嫌色细胞癌血供相对较少,强化程度明显低于透明细胞癌。结论各型肾细胞癌的CT表现的特异性并不强,最终分型仍依靠病理,仔细分析肾癌的CT影像特征与病理之间的关系有助于诊断与鉴别。Objective To analyze the feature of CT image combined with the pathological type of renal cell carcinoma to improve the diagnostic accuracy. Methods Collected 47 patients in our hospital pathologically con-firmed renal cell carcinoma. The preoperative CT scan and dynamic contrast enhanced CT scan were performed before the operation. Retrospective analysis of CT imaging characteristics and pathological findings were compared. Results There were 34 cases with clear cell carcinoma; 5 case multilocular cell carcinoma;3 case papillary renal carcinoma;4 cases chromophobe cell carcinoma and 1 case collecting duct carcinoma. Granular cell carcinoma and multilocular cell carcinoma were both classified as clear cell carcinoma in new pathological typing. With rich blood vessel, this subtype showed dramatic enhancement on CT image and simple cystic degeneration was the characteristic. While granular cell carcinoma and chromophobe cell carcinoma was relatively with poor blood vessel and the degree of en-hancement was lower than clear cell carcinoma. Conclusion The CT features in every subtype of renal cell carcino-ma show no obvious specificity and the pathology is still the base of confirmed diagnosis. Careful analysis of the rela-tionship between the CT imaging features and pathology of renal cell carcinoma contribute to the diagnosis and differ-ential diagnosis.

关 键 词：肾肿瘤 体层摄影术 X线计算机 病理学 

分 类 号：R737.11[医药卫生—肿瘤]