摘要
目的探讨16层螺旋CT多期扫描对小肾癌亚型的诊断价值。方法回顾性分析32例直径<3 cm的肾癌16层螺旋CT多期扫描图像,对经手术病理证实的透明细胞癌、乳头状癌、嫌色细胞癌的CT图像进行双盲法对比分析,比较肿瘤强化程度与模式(均匀、典型及主要周边强化)、强化峰值(动脉期、静脉期、排泄期的CT峰值)及有无钙化、坏死、囊变等情况。结果透明细胞癌与嫌色细胞癌、乳头状癌在强化程度上(Ct值)差异有统计学意义(P<0.05);乳头状癌与透明细胞癌、嫌色细胞癌在强化模式上有差异。透明细胞癌多期扫描均可出现强化峰值,而嫌色细胞癌及乳头状癌峰值均在静脉期出现强化峰值。32例患者病灶CT检出率为100.0%(32/32),定性诊断正确率为93.8%(30/32)。结论肿瘤的强化程度及模式是区别小肾癌的亚型最有价值的参数;强化峰值也有助于区分小肾癌的亚型。
Objective To investigate the value of the multi-slice spiral computed tomography（MSCT） in the differential diagnosis of subtypes of small renal cell carcinoma（sRCC）.Methods The MSCT images of 32 cases of sRCC（3cm） were retrospectively analyzed.Three pathologically confirmed sRCC subtypes,which included clear cell RCC（n=27）,papillary RCC（n=2）,and chromophobe RCC（n=3） were analyzed by double blind method.The enhancement degree and pattern（homogeneous,typical and predominantly peripheral）,enhancement peak values（corticomedullary,parenchymal,and excretory phases）,and the presence of calcification,necrosis,or cystic degeneration were evaluated.Results The degree of enhancement was significantly different between clear cell RCC and papillary RCC/chromophobe RCC（P0.05）.The patterns of enhancement were significantly different between papillary RCC and clear cell RCC/ chromophobe RCC（P0.05）.Enhancement peaks were detected in multi-stage scanning for clear cell RCC,but were only detected in the parenchymal stage in papillary RCC and chromophobe RCC.The detection rate of lesions by MSCT was 100.0%,and the accuracy rate was 93.8%.Conclusion The degree and pattern of enhancement are the most valuable parameters in the differentiatial diagnosis of the subtypes of small renal cell carcinoma.The enhancement peak values can also provide supplementary information.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第24期2717-2719,共3页
Chinese General Practice
关键词
肾肿瘤
体层摄影术
螺旋计算机
鉴别诊断
Kidney neoplasms
Tomography
spiral computed
Diagnosis
differential
