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目的:探讨多层螺旋CT动态增强扫描对不同类型小肾癌的诊断价值。方法:回顾性分析2013年4月至2016年4月间我院收治的经病理证实的小肾癌患者62例的CT平扫及三期动态增强扫描征象进行分析与比较。结果:肾透明细胞癌患者、肾乳头状细胞癌患者及肾嫌色细胞癌患者一般资料无统计学差异(P>0.05)。62例患者共检出低密度14例,等密度38例以及高密度10例。透明细胞癌以等密度居多(60.00%),乳头状细胞癌以等密度居多(70.43%),嫌色细胞癌以低密度居多(66.67%)。不同类型小肾癌患者CT平扫结果之间差异显著(P<0.05)。透明细胞癌以明显强化居多(77.14%),乳头状细胞癌以轻度强化居多(90.48%),嫌色细胞癌以中等强化居多(66.67%),不同类型间强化程度比较有统计学差异(P<0.05)。不同类型间强化模式以均匀强化及典型强化居多,三组差异不显著(P>0.05)。透明细胞癌三期CT值均显著高于乳头状细胞癌及嫌色细胞癌,差异有统计学意义(P<0.05),而乳头状细胞癌及嫌色细胞癌各期差异不显著(P>0.05)。三种类型小肾癌实质期CT值均显著高于其他两期,三期比较差异显著(P<0.05)。结论:多层螺旋CT动态增强扫描对于不同类型小肾癌的鉴别诊断具有积极的意义。
Objective: To investigate the diagnostic value of dynamic contrast-enhanced multislice spiral CT in different types of small renal cell carcinoma. Methods: A retrospective analysis of 62 cases of pathologically confirmed small renal cell carcinoma admitted from April 2013 to April 2016 in our hospital was performed. CT scanning and dynamic contrast-enhanced phase contrast imaging were analyzed and compared. Results: The data of renal clear cell carcinoma, papillary renal cell carcinoma and chromophobe renal cell carcinoma showed no statistical difference (P> 0.05). Totally 62 patients were detected in 14 cases of low density, 38 cases of equal density and 10 cases of high density. Clear cell carcinoma was mostly isodense (60.00%). Papillary carcinoma was mostly isodense (70.43%), while chromophobe was mostly low density (66.67%). There were significant differences in CT scan results between different types of small renal cell carcinoma (P <0.05). Clear cell carcinoma was significantly enhanced (77.14%), mildly enhanced papillary carcinoma (90.48%), and moderately stained cancerous cells (66.67%). There was a statistically significant difference between the two groups P <0.05). There was no significant difference between the three groups (P> 0.05). The CT value of the third stage of clear cell carcinoma was significantly higher than that of papillary and chromophobe cell carcinoma (P <0.05), while the difference of papillary and chromophobe cell carcinoma was not significant (P> 0.05). The CT value of the three types of small renal cell carcinoma was significantly higher than the other two phases, the third phase difference was significant (P <0.05). Conclusion: Multi-slice spiral CT dynamic contrast-enhanced scan has positive significance for the differential diagnosis of different types of small renal cell carcinoma.