多层螺旋CT对肾透明细胞癌的诊断及鉴别诊断价值  

The value of diagnosis and differential diagnosis of multi-slice computed tomography(MSCT) in renal clear cell carcinoma

作　　者：张惠锋[1] 郝亮[1] 杜芳[1] 徐鹏鹏[1] 杨汝春[2] 

机构地区：[1]杭州市中医院放射科,浙江杭州310007 [2]杭州市中医院肾内科,浙江杭州310007

出　　处：《中国现代医生》2016年第11期89-91,F0003,共4页China Modern Doctor

基　　金：浙江省自然科学基金资助项目(LY15H050006)

摘　　要：目的探讨肾透明细胞癌多层螺旋CT的影像特征及与其他亚型的鉴别方法。方法回顾性分析2008年1月～2015年6月61例肾癌患者的CT图像，分成透明细胞癌组和非透明细胞癌组。比较两组增强幅度与肿瘤的大小、有无钙化、囊变、坏死和肿瘤的扩散状况（肾包膜、静脉及淋巴结转移）情况。结果平扫肾透明细胞癌组CT值和非透明细胞癌组CT值差异无统计学意义（P〉0．05）。而皮质期和髓质期的透明细胞癌的CT值显著高于非透明细胞癌（P〈0．05）。结论肿瘤的增强程度是鉴别肾透明细胞癌和非透明细胞癌最有价值的参数。而肿瘤的大小、有无钙化、囊变、坏死和肿瘤的扩散状况对鉴别有一定的作用。Objective To evaluate the image feature of multi-slice computed tomography（MSCT） in analyzing the different diameter renal clear cell carcinoma and the identification methods of various subtypes. Methods The enhancement degree of 61 cases pathology-proven renal clear cell carcinoma during biphasic contrast enhanced spiral CT scans from January 2008 to June 2015 were retrospective analyzed. The renal clear cell carcinoma patients were divided into two groups with clear cell carcinoma group （CCRCC group） and non-clear cell carcinoma group（non-CCRCC group）. The correlation between enhanced extent and tumor size, calcification, cystic change, necrosis, tumor spread status including renal capsule, vein and lymph node metastasis were explored. Results There were no significant differences between the plain scan value or CT value between two groups（P〉0.05）. While significant differences between the CT value of CCRCC group and non-CCRCC group were found in cortex and medulla stage（P〈0.05）. Conclusion The enhanced spiral CT scan can accurately identify the characteristic of renal clear cell carcinoma and non-clear cell carcinoma. The enhanced degree provides a good channel in evaluating tumor size, calcification, cystic change, necrosis, tumor spread status including renal capsule, vein and lymph node metastasis.

关 键 词：体层摄影术 X线计算机 肾透明细胞癌 肿瘤扩散 诊断 

分 类 号：R737.11[医药卫生—肿瘤]