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目的通过分析肾集合管癌(CDC)的CT多期增强表现,总结该病影像学特征。方法回顾性分析、总结病理证实的5例CDC患者的临床和影像资料,所有病例均行CT平扫和增强扫描。从病灶的部位、大小形态、内部结构、强化程度、病灶周围结构及浸润、转移等征象分析CDC的特征,并与病理进行对照。结果发病部位,本组5例中,CDC位于右肾2例,左肾3例,除1例左肾CDC并发右肾透明细胞癌,余病例均为单发病灶。形态方面,4例呈分叶状,境界不清楚,1例类圆形,境界较清楚,形成“假包膜”。肿瘤大小2.5 cm×2.0 cm~8.0 cm×5.0 cm。内部结构,3例肿瘤呈实质性,2例呈囊实性。CDC实性部分平扫CT值略高于肾皮质、髓质(34.63±3.50比32.83±6.70,32.75±5.15,均P>0.05),多期增强扫描呈轻度-中度不均匀进行性强化,强化程度均低于肾皮质、髓质(均P<0.05)。5例均侵犯肾皮质,其中2例同时侵犯肾盂、肾盏。1例患侧肾静脉受侵犯;1例腹膜后淋巴结肿大,余未见淋巴结及远处脏器转移征象。结论 CDC的CT多期增强表现有一定的特征性,与其病理特点密切相关,确诊需依赖病理学检查。
Objective To summarize the imaging characteristics of the disease by analyzing the multi-phase CT enhancement of renal tubular carcinoma (CDC). Methods The clinical data and imaging data of 5 CDC patients confirmed by pathology were retrospectively analyzed. All patients underwent CT scan and enhanced scan. The characteristics of CDC were analyzed from the location of the lesion, the size and shape, the internal structure, the degree of enhancement, the structure around the lesion, infiltration and metastasis, and compared with the pathology. Results The incidence of the site, the group of 5 cases, CDC in the right kidney in 2 cases, 3 cases of left kidney, except for 1 case of left renal CDC complicated with right renal clear cell carcinoma, the remaining cases were single lesions. Morphology, four cases were lobulated, the state is not clear, a case of round, the realm of more clearly, the formation of “false envelope.” The tumor size was 2.5 cm × 2.0 cm ~ 8.0 cm × 5.0 cm. Internal structure, 3 cases of tumor was substantial, 2 cases were cystic solid. CDC solid part of the CT scan slightly higher than the renal cortex and medulla (34.63 ± 3.50 vs 32.83 ± 6.70,32.75 ± 5.15, all P> 0.05), multi-phase enhanced scan mild to moderate progressive sexual enhancement , Which were lower than that of renal cortex and medulla (all P <0.05). 5 cases were infiltrated renal cortex, of which 2 cases of violations of the renal pelvis, calyx. 1 case of ipsilateral renal vein invasion; 1 case of retroperitoneal lymph nodes, I did not see lymph nodes and distant organs metastasis signs. Conclusions CDC CT multi-phase enhanced performance has a certain characteristic, closely related with its pathological features, the diagnosis depends on pathological examination.