64层螺旋CT对囊性肾癌的诊断与鉴别诊断  

The Diagnosis and Differential Diagnosis of 64 Slice Spiral CT in Cystic Renal Cell Carcinoma

作　　者：张旭辉[1] 陈晓荣[1] 张珊珊[1] 

机构地区：[1]湖北医药学院附属东风医院影像科,湖北十堰442008

出　　处：《湖北医药学院学报》2016年第3期284-287,290,共5页Journal of Hubei University of Medicine

摘　　要：目的:分析15例囊性肾癌的CT平扫及增强表现,以提高64层螺旋CT对囊性肾癌的诊断及鉴别诊断水平。方法:收集2011-2015年15例囊性肾癌,经术后病理证实,回顾分析64层螺旋CT表现,行多平面重建(MPR)。结果:本组15例中,单房囊性肾癌8例,多房囊性肾癌7例,瘤体液性低密度影6例,9例瘤体混杂密度。13个病灶囊壁局部增厚,其中不均匀增厚11例,壁结节2例。瘤内分隔7例,间隔菲薄2个,不均匀增厚5例,并间隔结节2例。囊壁及分隔钙化2例。11例增强扫描动脉期显示囊壁、壁结节及囊内分隔明显强化,囊性部分强化不明显。实质期及延迟期壁结节及囊内分隔强化程度减低,低于肾实质。2例呈渐进性强化。结论:虽然囊性肾癌少见,但其64排螺旋CT有特征性改变,依据CT平扫及增强绝大多数囊性肾癌都能明确诊断。Objective To improve ）he. diagnostic anti differential diagnostic level of 64 slice spiral CT in cystic renal cell carcinoma through analyzing the CT plain scan and enhancement manifestaion of 15 patients with cystic renal cell carcinoma.Methods From 2011 to 2015,total 15 patients with cystic renal cell carcinoma were confirmed by postoperative pathologT.The CT manifestaion of 64 slice spiral CT were retrospectively analyzed and the muhiplanar reconstruction（MPR） was performed.ReSults In 15 patients, 8 cases were single room cystic renal cell carcinoma 7 cases were multilocular cystic renal cell carcinoma,6 cases were tumor fluid low density,9 cases were mixed tumor density.Local thickening of the cyst wall was found in 13 lesions,including 11 cases of uneven thickening and 2 cases of mural nodules. Intratumoral septum were found in 7 cases, small interval in 2 cases, uneven thickening in 5 cases and septal nodules in 2 cases.The contrast enhancement of 11 cases in arterial phase showed that cyst wall, mural nodules and intra capsular separation were enhanced obviously ,but the cystic part was not obviously enhanced.In parenehyreal phase and lag phase,the enhanced degree of mural nodules and intra capsular separation was decreased and lower than that of renal parenchyma.Two cases Showed progressive enhancement.Gonclusion Although cystic renal cell carcinoma is rare in clinical,but depending on its characteristic change in 64 slice spiral CT,most cystic renal cell carcinoma could be clearly diagnosed by CT plain scan and enhancement.

关 键 词：囊性肾癌 螺旋CT 诊断 鉴别诊断 

分 类 号：R737.11[医药卫生—肿瘤] R730.44[医药卫生—临床医学]