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目的：分析肾脏良恶性肿瘤的ＣＴ表现，探讨ＣＴ对该类疾病的诊断价值。材料和方法：对手术和病理证实的１０４例肾脏肿瘤进行回顾性分析，所有病例均行平扫和增强。结果：１０４例中，良性肿瘤６例（占５．８％），均为肾血管平滑肌脂肪瘤（ＡＬＬ），ＣＴ表现为肾实质内含多种不同成分的混杂密度肿块，可有分房、分隔，内含脂肪是其特征性表现，增强后软组织部分强化，而脂肪区无强化。恶性肿瘤９８例（占９４．２％），其中肾细胞癌（ＲＣＣ）８２例，ＣＴ表现为肾实质内形态不规则、边界欠清的低密度软组织块影，动态增强后可见一过性强化。应用动态薄层增强ＣＴ扫描法准确检出小肾癌（最大径＜３ｃｍ）８例，该法为目前检查小肾癌的最佳影像方法。肾盂癌１１例（均为移行细胞癌），ＣＴ表现为肾盂内分叶状低密度软组织块影，增强后病灶强化不明显。肾母细胞瘤（Ｗｉｌｍｓ瘤）５例，均为４岁（平均２．５岁）以下小儿，ＣＴ表现为肾实质部位较大的不规则较低密度软组织块影，增强后无明显强化。结论：增强前后ＣＴ扫描对肾脏肿瘤的定位、定性诊断及术前分期均具有十分重要的价值。
Objective: To analyze the CT findings of benign and malignant renal neoplasms and to explore the diagnostic value of CT in these diseases. Materials and Methods: A retrospective analysis was performed on 104 cases of renal tumors confirmed by surgery and pathology. All cases were scanned and enhanced. Results: In 104 cases, 6 cases (5.8%) of benign tumors were all angiomyolipoma of the kidney (ALL). The CT showed that the renal parenchyma contained heterogeneous mass with many different components, Separated, containing fat is its characteristic performance, enhanced soft tissue part of the enhancement, while the fat area without strengthening. Malignant tumors in 98 cases (94.2%), of which 82 cases of renal cell carcinoma (RCC), CT showed irregular internal morphology of the renal parenchyma, low-density border soft tissue block shadow, enhanced dynamic enhanced transient seen . Eight cases of small renal cell carcinoma (maximum diameter <3cm) were accurately detected by dynamic thin-layer enhanced CT scan. This method is the best imaging method for small renal cell carcinoma. Renal pelvis cancer in 11 cases (all are transitional cell carcinoma), CT showed pelvis lobular low-density soft tissue mass, enhanced lesion enhancement was not obvious. Nephroblastoma (Wilms tumor) in 5 cases, all 4-year-old children (average 2.5 years) below the CT, the performance of the renal parenchyma larger irregular lower density soft tissue mass enhancement did not significantly enhanced. Conclusion: CT scan before and after enhanced renal tumor localization, qualitative diagnosis and preoperative staging are of great value.