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目的探讨128排螺旋CT血管造影术在肾细胞癌术前分期中的应用。方法选取2008年1月至2017年1月陕西核工业二一五医院收治的88例肾细胞癌患者,回顾性分析患者的CT血管造影术图像,观察肿瘤侵犯范围,淋巴结是否转移,是否发生远处转移等。采用ROBSON外科分期法对肾细胞癌进行CT分期,与术后病理分期进行比较,分析128排螺旋CT血管造影术对肾细胞癌术前分期的准确性。结果患者128排螺旋CT分期:I期36例,Ⅱ期28例,Ⅲa期12例,Ⅲb期4例,Ⅲc期4例,Ⅳa期2例,Ⅳb期2例。病理分期:I期33例,Ⅱ期30例,Ⅲa期13例,Ⅲb期3例,Ⅲc期4例,Ⅳa期3例,Ⅳb期2例。CT分期与病理分期符合率:I期91.7%,Ⅱ期93.3%,Ⅲa期92.3%,Ⅲb期75.0%,Ⅲc期100.0%,Ⅳa期66.7%,Ⅳb期100.0%。结论 128排螺旋CT血管造影术能很好地显示肾细胞癌的影像学特征,分期准确,值得临床推广。
Objective To investigate the application of 128-slice spiral CT angiography in the preoperative staging of renal cell carcinoma. Methods Eighty-eight patients with renal cell carcinoma admitted from January 2008 to January 2017 in Shaanxi Nuclear Industry Hospital were retrospectively analyzed. CT angiography was performed to observe the extent of tumor invasion and lymph node metastasis. Department transfer and so on. ROBSON surgical staging was used to evaluate the staging of renal cell carcinoma by CT staging. The accuracy of 128-slice CT angiography was compared with preoperative staging of renal cell carcinoma. Results The 128-slice spiral CT staging was 36 cases in stage I, 28 cases in stage Ⅱ, 12 cases in stage Ⅲa, 4 cases in stage Ⅲb, 4 cases in stage Ⅲc, 2 cases in stage Ⅳa and 2 cases in stage Ⅳb. Pathological stage: 33 cases of stage I, 30 cases of stage II, 13 cases of stage IIIa, 3 cases of stage IIIb, 4 cases of stage IIIc, 3 cases of stage IVa, and 2 cases of stage IVb. The coincidence rate of CT staging and pathological staging was 91.7% in stage I, 93.3% in stage Ⅱ, 92.3% in stage Ⅲa, 75.0% in stage Ⅲb, 100.0% in stage Ⅲc, 66.7% in stage Ⅳa and 100.0% in stage Ⅳb. Conclusion 128-slice spiral CT angiography can well show the imaging features of renal cell carcinoma, staging accurately, it is worth clinical promotion.