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目的:评价血管造影尤其药物血管造影对小肾癌的诊断和鉴别诊断价值。材料与方法:26例直径3cm 以下肾脏小肿物血管造影前均进行了二维超声和 CT 平扫与增强检查。先行腹主动脉和肾动脉的标准血管造影,然后根据动脉造影表现确定是否再行药物性血管造影。后者是指先经肾动脉注入肾上腺素10μg,10～20秒后再行肾动脉造影。并对 CT、超声和血管造影的诊断结果做了统计分析与对比。结果:26例肾脏病变最后确定依断小肾癌14例,良性病性变12例。血管造影对该组小肾癌诊断检出率、特异性及符合率分别为:92.9%、91.7%、和92.3%;CT 为85.7%、16.7%和53.8%;超声为64.3%、33.3%和50.0%。血管造影与CT 和超声的特异性之间存在显著性差异。结论:血管造影尤其是药物血管造影对小肾癌的诊断和鉴别诊断具有重要价值。
Objective: To evaluate the value of angiography, especially drug-induced angiography in the diagnosis and differential diagnosis of small renal cell carcinoma. MATERIALS AND METHODS: Two-dimensional ultrasonography and CT plain scan and contrast enhancement were performed in 26 cases of small renal masses below 3 cm in diameter before angiography. First of all, the standard abdominal aorta and renal angiography, angiography and angiography, and then determine whether to re-run the drug angiography. The latter refers to the first renal artery injection of epinephrine 10μg, 10 to 20 seconds after the renal artery angiography. And CT, ultrasound and angiography diagnostic results made a statistical analysis and comparison. Results: Twenty-six cases of renal disease were diagnosed as small renal cell carcinoma in 14 cases and benign disease in 12 cases. The diagnostic rate, specificity and coincidence rate of angiography in this group of small renal cell carcinoma were 92.9%, 91.7% and 92.3% respectively; CT was 85.7%, 16.7% and 53.8%; ultrasonography was 64.3% and 33.3% respectively 50.0%. There was a significant difference between the specificity of angiography and CT and ultrasound. Conclusion: Angiography, especially drug angiography, is of great value in the diagnosis and differential diagnosis of small renal cell carcinoma.