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目的:探讨分次团注双期CT增强扫描在肾透明细胞癌中的临床应用价值。方法:选择我院B超或体检中怀疑肾脏占位患者120例,采用随机数字表法按照病例进行检查的先后顺序随机分成两组:实验组(60例)行肾脏分次团注双期CT增强扫描,对照组(60例)行常规三期增强扫描。术后对照病理结果,选择肾脏透明细胞癌患者共90例作为研究对象,实验组44例,对照组46例(120例患者中肾脏透明细胞癌患者共90例,选择这90例患者为研究对象,其中来自实验组的44例,来自对照组46例)。对(最终纳入的90例肾脏透明细胞癌)患者CT扫描各期病变及健肾实质强化程度进行对比分析;计算两组患者所受有效辐射剂量。结果:①实验组肾透明细胞癌皮质期、实质-排泄期与对照组皮质期、排泄期平均CT值之间无统计学意义(P=0.064,P=0.105);实验组肾透明细胞癌实质-排泄期与对照组实质期平均CT之间具有统计学意义(P=0.000);②实验组健肾实质皮质期与对照组皮质期平均CT值之间无统计学意义(P=0.510);实验组健肾实质-排泄期与对照组实质期及排泄期强化平均CT值之间具有统计学差异(P=0.000,P=0.001)。③实验组的平均有效剂量较对照组减低30%。结论:肾脏分次团注双期增强扫描在定性诊断肾脏占位性病变的同时明显降低患者检查所受有效辐射剂量,具有重要临床应用价值。
Objective: To investigate the clinical value of double-phase CT enhanced scanning in renal clear cell carcinoma. Methods: One hundred and twenty patients suspected of occupying the kidney in B-ultrasound or physical examination in our hospital were randomly divided into two groups according to the order of random number table. The experimental group (60 cases) Enhanced scanning, the control group (60 cases) routine three enhanced scan. According to the pathological results, 90 patients with clear cell renal cell carcinoma were selected as the experimental group, 44 in the experimental group and 46 in the control group (90 patients with clear cell renal cell carcinoma in 120 patients, 90 patients were selected as the research object , Of which 44 from the experimental group, 46 from the control group). Contrast analysis was made on the lesions of CT scan (the final 90 cases of clear cell renal cell carcinoma included) and the degree of enhancement of renal parenchyma. The effective radiation dose of two groups of patients was calculated. Results: ① There was no significant difference between the experimental group (P = 0.064, P = 0.105), the mean CT value of cortical phase, parenchyma-excretion phase and control group in the stage of clear cell carcinoma - There was a significant difference between the excretion period and the control group CT (P = 0.000). ② There was no significant difference between the experimental group and the control group (P = 0.510). There was a significant difference (P = 0.000, P = 0.001) between experimental group and renal parenchymal - excretion phase in control group and parenchymal phase in excretion phase. The experimental group, the average effective dose was reduced by 30% compared with the control group. CONCLUSION: Double-phase renal enhancement group scans with double-phase enhanced scans in the qualitative diagnosis of renal space-occupying lesions significantly reduce the effective dose of radiation examination of patients with an important clinical value.