摘要
目的:评价螺旋CT多期增强扫描在小肾癌诊断中的价值,探讨其扫描计划。方法:回顾性分析17例经病理证实的小肾癌(≤3 cm)在平扫和皮质期(动脉期和静脉期)、实质期及肾盂期的螺旋CT增强表现。结果:CT平扫实性15例,囊实性1例,囊性1例。增强扫描动脉期11例呈明显全瘤性强化,密度等于或稍高于肾皮质;4例呈轻中度强化,稍低于肾皮质;2例呈不均匀或分隔状或边缘强化。静脉期强化稍低于肾皮质。实质期肿瘤强化迅速减退,肾盂期肿瘤强化进一步减退。5例肿瘤边缘可见假包膜。结论:螺旋CT多期增强扫描在小肾癌的诊断中较常规CT有明显优越性,多数小肾癌动脉期强化明显,实质期强化迅速减退,肾盂期呈更低密度,呈"快进快退"表现,有重要的定性意义。加扫静脉期图像有利于观察小肾癌与正常肾皮质强化模式的区别,避免假阴性或假"驼峰肾"的出现。扫描计划应包括平扫和皮质期、实质期及肾盂期增强扫描。
Objective： To evaluate muhiphasic enhancement of spiral CT scan in the diagnosis of small renal cell carcinoma（SRCC） and to investigate the protocol of scan. Methods：What the spiral CT features of SRCC （3 cm or less in diameter）during plain scan and different enhancement phases such as cortical （artery and vein phase）, parenehymal and pyelographic phases were proved with pathology in 17 cases were retrospectively analyzed. Results：In 17 cases, 15 were solid mass, 1 was cystic- solid mass and 1 was cystic mass. In 15 cases of solid SRCC, 11 cases showed marked tumor enhancement in artery phase, in another 4 cases the enhancement was slight and moderate. 2 case of small cystic RCC showed enhancement of asymmetry or partition or edge. Enhancement of SRCC in vein phase was a little and lower than that of renal cortical. In parenchymal phase and pyelographic phases the tumor density dropped promptly. The pseudocapsules were showed in 5 cases. Conclusion： The multiphasic enhancement of spiral CT scan is more superior than conventional CT in diagnosis of SRCC. In more cases, tumor enhancement was strong in artery phase, but weak in parenehymal phase and pyelographic phases. They demonstrate the ＂fast washing out＂ phenomenon, which is characteristic pattern of enhancement. The scanning in vein phase is needed for the diagnosis of SRCC, it can help to differentiate tumor from renal cortical and avoid error diagnosis. The protocol must include plain scan and different enhancement phases such as cortical, parenehymal and pyelographie phases.
出处
《现代临床医学》
2012年第6期440-441,共2页
Journal of Modern Clinical Medicine
关键词
小肾癌
体层摄影术
X线计算机
增强扫描
small renal cell carcinoma
tomography, X -ray computer
enhancement scanning
作者简介
通讯作者：林云，2521997413@qq．com
