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目的分析并总结肾盂癌的CT表现以及诊断价值。方法回顾性分析自2008年11月至2010年11月期间实施手术以及通过病理证实的肾盂癌患者46例的CT表现特点。结果全部46例患者均进行CT平扫,查出病灶位于左肾者44例,位于右肾者2例。平扫显示肾盂、肾盏内可疑结节以及包块影,同肾实质呈相等或稍低的密度,伴有肾盂积水者22例。实施强化扫描者36例,增强早期肿瘤结节和包块强化不显著;在实质期表现为轻至中等密度的强化,并且在皮髓质交界相不清晰,同侧肾皮质强化比不上对侧;在延迟期肾盂或肾盏内部表现为不规则充盈缺损,内部被软组织密度所填充。CT诊断和病理诊断的一致率达到95.89%。患者中有6例疑诊肾癌侵及肾盂,2例患者疑诊为肾多发结石,2例疑诊为肾盂肾炎。结论肾盂癌的CT表现具有其自身的特点,动态增强扫描能够体现肿瘤的强化特征,给临床诊断提供有价值的鉴别依据。
Objective To analyze and summarize the CT findings and diagnostic value of renal pelvic cancer. Methods The CT findings of 46 patients with renal pelvic cancer who were surgically and pathologically confirmed from November 2008 to November 2010 were retrospectively analyzed. Results All 46 patients underwent CT plain scan, and 44 lesions were found in the left kidney and 2 in the right kidney. Plain display renal pelvis, calyx suspicious nodules and mass shadow, with the renal parenchyma was equal to or slightly lower density, with hydronephrosis in 22 cases. Thirty-six patients underwent intensive scanning, which showed no obvious enhancement of early tumor nodules and masses. In the period of parenchymal enhancement, they showed mild to moderate density and were not clear at the junction of cortex medulla, Side; within the delay renal pelvis or calyx internal irregular filling defect, the internal density was filled by the soft tissue. The coincidence rate of CT diagnosis and pathological diagnosis reached 95.89%. 6 cases of patients with renal cell carcinoma invaded the renal pelvis, 2 patients suspected kidney multiple stones, 2 cases of suspected pyelonephritis. Conclusions CT manifestations of renal pelvic cancer have their own characteristics. Dynamic contrast-enhanced scanning can reflect the enhanced features of tumors and provide valuable evidences for clinical diagnosis.