肾嗜酸细胞腺瘤与肾细胞癌的CT鉴别诊断  

CT DIFFERENTIAL DIAGNOSIS OF RENAL ONCOCYTOMA AND RENAL CELL CARCINOMA

作　　者：齐鹏飞[1,2] 张凡[1] 强军[2] 高万勤[2] 

机构地区：[1]商丘医学高等专科学校,河南商丘476100 [2]河南科技大学第一附属医院

出　　处：《齐鲁医学杂志》2016年第4期388-390,394,共4页Medical Journal of Qilu

基　　金：河南省商丘市2013年科技发展计划项目(135011)

摘　　要：目的探讨肾嗜酸细胞腺瘤与肾细胞癌的CT鉴别诊断要点。方法回顾性分析经手术病理证实的9例肾嗜酸细胞腺瘤与33例肾细胞癌的CT资料。结果 9例肾嗜酸细胞腺瘤均为单发,平扫9例皆密度均匀或主体密度均匀,其中8例呈等或低密度,边缘不清,1例呈稍高密度,5例中央可见低密度瘢痕影;增强扫描5例表现为一过性强化,中央可见星状或小片状无明显强化区;4例表现为快进缓出型强化,皮髓质期不均匀强化,实质期、排泄期强化趋于均匀。肾细胞癌33例中,平扫22例呈低、等或混杂密度,增强扫描27例表现为不均匀一过性强化;14例可见静脉瘤栓及其他脏器转移等征象。结论中央星状瘢痕和延迟期均匀强化有助于肾嗜酸细胞腺瘤与肾细胞癌的鉴别诊断。Objective To discuss the key points of CT differential diagnosis of renal oncocytoma（ROC）and renal cell carcinoma（RCC）. Methods CT data of nine cases of ROC and 33 cases of RCC,confirmed by operation and pathology,were retrospectively reviewed. Results CT manifestations of the nine cases of ROC were as follows：all were single.A plain scan showed：uniform density or uniform density of main body,of which,eight showed equal or low density with obscure boundary,and one with slightly higher density.Low density scar image seen in five.Enhancement scanning indicated that：transient enhancement was noted in five cases,a star-like or small piece of no obvious enhancement zone could be seen.Four manifested as＂fast in and slow out＂enhancement,uneven enhancement was noted in medullary phase,and in parenchymal phase and excretion phase,the enhancement tended to be uniform.In 33 cases of RCC,22 appeared low or mixed density in plain scan,and in enhanced scan,27 manifested non-uniform transient enhancement,venous tumor thrombus and other organ metastasis were found in 14 cases.Conclusion Central stellate scar and homogeneous enhancement in delay period are conducive to the differential diagnosis of renal oncocytoma and renal cell carcinoma.

关 键 词：肾肿瘤 体层摄影术 X线计算机 诊断 鉴别 

分 类 号：R737.11[医药卫生—肿瘤]