摘要
目的旨在探讨多层螺旋CT多期扫描对肾占位性病变的诊断及鉴别诊断价值。方法选取我院2015年8月~2017年11月收治的肾占位性病变患者80例,所有患者均进行多排螺旋CT平扫及增强扫描,整理80例患者的临床及影像学资料,以手术或病理活检结果做参照,计算CT平扫及多期增强扫描肾占位性病变的鉴别诊断价值。结果 CT平扫对不同类型肾占位性病变的总检出率、诊断符合率分别为85.00%(68/80)、71.25%(57/80),低于多期增强扫描100%(80/80)、97.50%(78/80),差异具有统计学意义(χ~2分别为12.973、20.907,P<0.001);肾囊肿CT平扫表现为典型边界清晰的囊性病灶,平均CT值为15HU,形态多为类圆形,囊壁薄,多期增强扫描中未见明显强化;结核性脓肾CT平扫主要为多发囊状低密度区,直径0.5cm,多期增强扫描中呈现轻度强化;肾血管平滑肌瘤瘤体形态多为类圆形,最小径2.4cm,最大径10.96cm,6例患者平扫为稍低密度影,3例瘤体呈现稍高密度影,2例瘤体呈现混杂密度,多期增强扫描明显强化;肾盂癌病灶外形不规则,肾盂期增强扫描可见肾盂内充盈缺损,6例患者累及肾实质;肾癌平均最大径(6.12±1.03)cm,多位于上级,6例患者表现为明显强化,18例患者呈现轻-中度强化,出血、囊性改变区域未见明显强化。结论多层螺旋CT多期扫描可有效显示对不同肾占位性病变的图像特征,检出率及诊断符合率高,可为临床提供相关影像学资料。
Objective To explore the value of multi-slice spiral CT in the diagnosis and differential diagnosis of renal space-occupying lesions. Methods 80 patients with renal space-occupying lesions admitted to our hospital from August 2015 to November 2017 were selected. All patients underwent multi-slice spiral CT plain and enhanced scanning. The clinical and imaging data of 80 patients were collected and compared with the results of operation or pathological biopsy. The differential diagnostic value of CT plain scan and multi-phase enhanced scan for renal space-occupying lesions was calculated. Results The total detection rate and diagnostic coincidence rate of CT plain scan were 85.00%(68/80) and 71.25%(57/80), respectively, lower than 100%(80/80) and 97.50%(78/80) of multiphase enhanced scan(χ~2=12.973, 20.907, P<0.001). CT plain scan of renal cysts showed typical well-defined cystic lesions with an average CT value of 15 HU. Most of the cysts were round in shape and thin in wall. There was no obvious enhancement in multiphase enhanced scan. CT plain scan of tuberculous pyonephrosis was mainly composed of multiple cystic low-density areas with a diameter of 0.5 cm, and showed mild enhancement in multi-phase enhanced scan. The shape of renal angiomyoma was mostly round, with a minimum diameter of 2.4 cm and a maximum diameter of 10.96 cm. Six patients had slightly low density on plain scan, three had slightly high density on plain scan, and two had mixed density on multiphase enhanced scan. The lesion of renal pelvic carcinoma was irregular in shape. Renal pelvic filling defect could be seen on enhanced scan during the pelvic phase. Renal parenchyma was involved in 6 cases. The mean maximum diameter of renal cell carcinoma was(6.12±1.03) cm, mostly located at the superior level. Six patients showed marked enhancement, 18 patients showed mild to moderate enhancement, and no obvious enhancement of hemorrhage and cystic change areas. Conclusion Multiphase spiral CT scanning can effectively display the image features of different renal space-occupying lesions, and the detection rate and diagnostic coincidence rate are high. It can provide relevant imaging data for clinic.
作者
陈红兵
罗英女
CHEN Hong-bing;LUO Ying-Nv(Department of Nephrology,Jingzhou Hospital of Traditional Chinese Medicine,Jingzhou 434001,Hubei Province,China)
出处
《中国CT和MRI杂志》
2020年第6期115-117,139,共4页
Chinese Journal of CT and MRI
基金
湖北省卫生计生委医药院校专项立项(编号:WJ2016Y23)。
关键词
多层螺旋CT
多期扫描
肾占位性病变
诊断
鉴别诊断
Multi-slice Spiral CT
Multi-phase Scanning
Renal Space-occupying Lesions
Diagnosis
Differential Diagnosis
