摘要
目的 探讨WHO病理分类中不同亚型肾细胞癌（renal cee carcinoma,RCC）的CT特征,旨在加深对RCC的认识,提高影像诊断准确率.方法 回顾性分析2008年1月～2013年9月72例经病理证实的RCC患者的临床资料及CT检查结果,其中透明细胞癌58例,乳头状细胞癌7例,嫌色细胞癌4例,多房囊性肾癌3例.结果 透明细胞癌平扫病灶呈等或低密度,增强扫描皮质期肿瘤多呈不均性明显强化,实质期、分泌期强化减退.乳头状细胞癌多呈等密度或囊实性,增强扫描皮质期实性部分轻度强化,实质期、分泌期延迟强化.嫌色细胞癌多位于肾髓质内,密度均匀,增强扫描强化均匀,坏死、囊变少见.多房囊性肾癌位于肾皮质区,由多个囊腔和分隔构成,囊壁及间隔菲薄,无附壁结节,平扫病灶呈低密度,增强扫描囊壁、间隔延迟强化.结论 不同病理亚型肾细胞癌CT特征、手术方案、预后均不同,术前影像学检查准确诊断能够为临床医师选择合理手术方案提供可靠依据.
Objective To compare and analyze the CT features of different renal cell carcinoma （RCC） subtypes by WHO,aiming to deepen the understanding of RCC and to increase the imaging diagnostic accuracy.Methods We retrospectively analyzed clinical data and results of CT examination of 72 cases with RCC confirmed histopathology,including 58 cases of clear cell carcinoma,7 cases of papillary carcinoma,4 cases of chromophobe renal cell carcinoma,and 3 cases of multilocular cystic renal cell carcinoma.Results Clear cell carcinoma were shown equal or low density,heterogeneous enhancement in cortex phase,and decreased enhancement in parenchymal phase and the excretory phase.Papillary cell car cinoma appeared as iso-density or cystic,solid components showed mild enhancement in cortex phase and delay strengthening in parenchymal phase,secretory phase.Chromophobe cell carcinoma was always located at renal medulla and shown uniform density and enhancement with rarely necrosis and cystic change.Multilocular cystic renal cell carcinoma was in renal cortex and composed of multiple cysts and thin septa without mural nodules.Cysts showed lower density and cyst wall,septa showed delayed enhancement.Conclusion Different pathological subtypes of renal cell carcinoma have different CT characteristics,operation plan and prognosis.Accurate preoperative imaging diagnosis can provide reliable basis for clinicians to choose reasonable operation plan.
出处
《医学影像学杂志》
2014年第3期417-420,469,共5页
Journal of Medical Imaging
作者简介
吴小光（1973-）,男,浙江丽水人,本科,主治医师,擅长腹部疾病CT诊断工作
