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目的分析小肾癌16层螺旋CT平扫和多期动态增强扫描表现,研究其CT表现和与病理类型的关系。方法收集经手术病理证实的小肾癌18例,行16层螺旋CT平扫和动脉期、静脉期、髓质期和肾盂期增强扫描。结果 CT平扫15例为等或低密度,3例为高密度,2例有斑点状钙化。静脉注射对比剂后,动脉期(皮质期)扫描12例癌灶明显强化,等于或稍高于肾皮质;3例癌灶轻中度强化,稍低于肾皮质;3例癌灶呈不均匀强化或边缘强化。全部癌灶动脉期CT值较平扫增加80-110HU。静脉期(皮髓质分界期)扫描全部癌灶强化稍低于肾皮质。髓质期及肾盂期全部癌灶强化迅速减退,呈“快进快退”改变。病理检查:13例为透明细胞癌,3例为颗粒细胞癌,2例为混合型。结论 16层螺旋CT多期增强扫描对小肾癌有较高的诊断价值。
Objective To analyze the 16-slice spiral CT plain scans and multi-phase dynamic contrast-enhanced scans of small renal cell carcinoma and to study the relationship between the CT features and pathological types. Methods Eighteen patients with small renal cell carcinoma confirmed by pathology were collected and scanned by 16-slice spiral CT and arterial phase, venous phase, medullary phase and renal pelvis enhancement scan. Results CT scan of 15 cases of equal or low density, 3 cases of high density, 2 cases of speckled calcification. Intravenous injection of contrast agent, arterial phase (cortical) scan of 12 cases of foci significantly enhanced, equal to or slightly higher than the renal cortex; 3 cases of mild to moderate focal enhancement, slightly lower than the renal cortex; 3 cases were uneven Strengthen or strengthen the edge. All lesions of the arterial phase CT value increased compared with plain scan 80-110HU. Venous phase (cutaneous cortical cut-off period) scan all the lesion was slightly lower than the renal cortex. Medullary and renal pelvic cancerous lesions intensified rapidly diminished, was “fast forward rewind” change. Pathological examination: 13 cases of clear cell carcinoma, 3 cases of granulosa cell carcinoma, 2 cases were mixed. Conclusion 16-slice spiral CT multi-phase enhanced scan has a high diagnostic value for small renal cell carcinoma.