CT在肾实质型尿路上皮癌诊断及鉴别诊断中的价值  

The value of CT in the diagnosis and differential diagnosis of renal parenchymal urothelial carcinoma

作　　者：王洁琼 赵静 陈小军 WANG Jieqiong;ZHAO Jing;CHENXiaojun(Department of Radiology,Taikang Xianlin Drum Tower Hospital,the Affiliated Hospital of Nanjing UniversityMedical School,Nanjing 210046,China;Department of Radiology,Eastern Theater General Hospital,Qinhuai District Medical Area,Nanjing 210002,China)

机构地区：[1]南京大学医学院附属泰康仙林鼓楼医院放射科,江苏南京210046 [2]东部战区总医院秦淮医疗区放射科,江苏南京210002

出　　处：《实用放射学杂志》2024年第5期772-775,共4页Journal of Practical Radiology

摘　　要：目的分析肾实质型尿路上皮癌与其他肾脏浸润性病变的CT影像特征,提高肾实质型尿路上皮癌的诊断及鉴别诊断正确率。方法收集60例经病理证实肾盂肾实质均受累的肾脏浸润性病变患者的临床及影像资料(其中27例肾实质型尿路上皮癌,20例肾乳头状细胞癌,13例肾淋巴瘤),所有患者均行CT平扫及3期增强扫描;分析其临床表现及其影像特点,测量平扫及3期增强扫描肿瘤/皮质CT比值,并进行统计学分析。结果部分肾乳头状细胞癌患者的肾脏轮廓有改变,局部突出于轮廓外;其余患者肾脏形态尚可,呈肾段或全肾受累,皮髓质分界不清。3种肿瘤均呈轻中度渐进性强化。3组病例平扫的肿瘤/皮质CT比值差异无统计学意义(P>0.05),3期增强扫描的肿瘤/皮质CT比值差异有统计学意义(P<0.05)。结论肾实质型尿路上皮癌与其他肾脏浸润性病变的影像表现不同,在强化峰值期相上差异显著。Objective To analyze the CT imaging features of renal parenchymal urothelial carcinoma and other renal infiltrative lesions,and to improve the diagnostic and differential diagnostic accuracy of renal parenchymal urothelial carcinoma.Methods The clinical and imaging data from 6o patients with renal infiltrative lesions involving both the renal pelvis and renal parenchyma confirmed by pathology were collected,including 27 cases of renal parenchymal urothelial carcinoma,20 cases of renal papillary cell carcinoma,and 13 cases of renal lymphoma.All patients underwent plain and three-phase enhanced scans.Clinical manifestations and imaging features were analyzed,and the tumor/cortex CT ratio was measured on plain and three-phase enhanced scans,and statistically analyzed.Results The renal contour of some patients with renal papillary cell carcinoma was altered and locally protruded beyond the contour,while the remaining patients had a normal renal morphology,with involvement of either a renal segment or the entire kidney,and unclear cortex-medulla differentiation.All three types of tumors showed mild to moderate progressive enhancement.The tumor/cortex CT ratio on plain scan had no statistical significance among the three groups(P>0.05),while the tumor/cortex CT ratio on three-phase enhanced scan showed statistical significance(P<0.05).Conclusion There are differences in imaging manifestations between renal parenchymal urothelial carcinoma and other renal infiltrative lesions,with significant differences in the phase of peak enhancement.

关 键 词：肾实质型尿路上皮癌 肾脏浸润性病变 计算机体层成像 鉴别诊断 

分 类 号：R737.11[医药卫生—肿瘤] R692[医药卫生—临床医学] R814.42