中国医学影像学杂志
中國醫學影像學雜誌
중국의학영상학잡지
CHINESE JOURNAL OF MEDICAL IMAGING
2014年
10期
755-759
,共5页
魏晋艳%岳松虹%刘宏%周俊林
魏晉豔%嶽鬆虹%劉宏%週俊林
위진염%악송홍%류굉%주준림
肾肿瘤%肾疾病,囊性%癌,肾细胞%癌,乳头状%腺癌,透明细胞%体层摄影术,螺旋计算机%病理学,外科%诊断,鉴别
腎腫瘤%腎疾病,囊性%癌,腎細胞%癌,乳頭狀%腺癌,透明細胞%體層攝影術,螺鏇計算機%病理學,外科%診斷,鑒彆
신종류%신질병,낭성%암,신세포%암,유두상%선암,투명세포%체층섭영술,라선계산궤%병이학,외과%진단,감별
Kidney neoplasms%Kidney diseases,cystic%Carcinoma,renal cell%Carcinoma,papillary%Adenocarcinoma,clear cell%Tomography,spiral computed%Pathology,surgical%Diagnosis,differential
目的：探讨肾癌囊性改变的CT表现特点，并与病理对照分析，以提高对此类肾癌的鉴别能力。资料与方法回顾性分析经手术病理证实的44例囊性改变肾癌，包括多房囊性肾癌10例、透明细胞癌21例、乳头状细胞癌13例，比较3组病例的CT征象。结果10例多房囊性肾癌均呈多房性改变，囊液平均CT值为（15.8±5.6) HU，囊壁及分隔较薄，4例壁结节直径>5 mm，8例囊壁及间隔呈早期中度强化。21例透明细胞癌中，9例呈多房性改变，囊液平均CT值为（32.5±6.7）HU，囊壁及间隔较厚，19例壁结节直径>5 mm，20例呈“快进快出”明显强化。13例乳头状细胞癌中，4例呈多房性改变，囊液平均CT值为（26.1±5.6）HU，囊壁及间隔较厚，12例壁结节直径>5 mm，12例呈轻至中度延迟强化。结论肾癌囊性改变的CT表现具有特征性，肿瘤有无假包膜、囊液CT值、囊壁及分隔厚度、附壁结节大小、边界及强化方式均有利于其鉴别诊断。
目的：探討腎癌囊性改變的CT錶現特點，併與病理對照分析，以提高對此類腎癌的鑒彆能力。資料與方法迴顧性分析經手術病理證實的44例囊性改變腎癌，包括多房囊性腎癌10例、透明細胞癌21例、乳頭狀細胞癌13例，比較3組病例的CT徵象。結果10例多房囊性腎癌均呈多房性改變，囊液平均CT值為（15.8±5.6) HU，囊壁及分隔較薄，4例壁結節直徑>5 mm，8例囊壁及間隔呈早期中度彊化。21例透明細胞癌中，9例呈多房性改變，囊液平均CT值為（32.5±6.7）HU，囊壁及間隔較厚，19例壁結節直徑>5 mm，20例呈“快進快齣”明顯彊化。13例乳頭狀細胞癌中，4例呈多房性改變，囊液平均CT值為（26.1±5.6）HU，囊壁及間隔較厚，12例壁結節直徑>5 mm，12例呈輕至中度延遲彊化。結論腎癌囊性改變的CT錶現具有特徵性，腫瘤有無假包膜、囊液CT值、囊壁及分隔厚度、附壁結節大小、邊界及彊化方式均有利于其鑒彆診斷。
목적：탐토신암낭성개변적CT표현특점，병여병리대조분석，이제고대차류신암적감별능력。자료여방법회고성분석경수술병리증실적44례낭성개변신암，포괄다방낭성신암10례、투명세포암21례、유두상세포암13례，비교3조병례적CT정상。결과10례다방낭성신암균정다방성개변，낭액평균CT치위（15.8±5.6) HU，낭벽급분격교박，4례벽결절직경>5 mm，8례낭벽급간격정조기중도강화。21례투명세포암중，9례정다방성개변，낭액평균CT치위（32.5±6.7）HU，낭벽급간격교후，19례벽결절직경>5 mm，20례정“쾌진쾌출”명현강화。13례유두상세포암중，4례정다방성개변，낭액평균CT치위（26.1±5.6）HU，낭벽급간격교후，12례벽결절직경>5 mm，12례정경지중도연지강화。결론신암낭성개변적CT표현구유특정성，종류유무가포막、낭액CT치、낭벽급분격후도、부벽결절대소、변계급강화방식균유리우기감별진단。
Purpose To explore the CT features of renal cell carcinoma with cystic change and to compare them with pathological ifndings, so as to improve its diagnostic accuracy. Materials and Methods A retrospective study was carried out in 44 cases of renal cell carcinoma with cystic change conifrmed surgically and pathologically, among which 10 were multilocular cystic renal cell carcinoma, 21 were renal clear cell carcinoma and 13 were papillary renal cell carcinoma. The CT features of these 3 kinds of diseases were analyzed comparatively. Results All of 10 cases of multilocular cystic renal cell carcinoma appeared to have multilocular cysts with thin cystic walls and septa. The mean CT value of cyst was (15.8±5.6) HU. The diameter of wall nodule was larger than 5 mm in 4 cases. The contrast-enhanced CT scan showed that the cystic walls and septa had early moderate enhancement in 8 cases. Among 21 cases of renal clear cell carcinoma, 9 presented to have multilocular cysts with thick cystic walls and septa. The mean CT value of cyst was (32.5±6.7) HU. The diameter of wall nodule was larger than 5 mm in 19 cases. The cystic walls and septa had obvious early enhancement in 20 cases. As to the 13 cases of papillary renal cell carcinoma, 4 appeared to have multilocular cysts with thick cystic walls and septa. The mean CT value of cyst was (26.1±5.6) HU. The diameter of wall nodule was larger than 5mm in 12 cases, and 12 cases appeared to have slight to moderate delayed enhancement. Conclusion The CT features of renal cell carcinoma with cystic change could be used in differential diagnosis, such as with or without pseudocapsule, mean CT value of cyst, thickness of cystic wall and septum, size, boundary, and enhancement of nodule.
