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目的 比较高场强MRI与螺旋CT平扫与动态增强检查对肾癌的诊断价值。方法 47例肾内实性占位病变 ,包括肾细胞癌 3 4例 ,少或无脂肪血管平滑肌脂肪瘤 4例 ,复杂囊肿 8例 ,肾嗜酸性细胞瘤 1例 ,均经 1.5TMRI及螺旋CT平扫及多期动态增强检查 ,CT与MRI检查时间间隔 2d～ 1月。所有病例均经手术病理证实。结果 高场强MRI检查对肾癌诊断的敏感度和准确度分别为 97.1%、89.4% ,高于螺旋CT检查的敏感度和准确度 (91.2 %、83 .0 % )。其诊断准确度有显著差异性 ,Ρ <0 .0 5。MRI检查对不典型肾癌、小肾癌及肾内不典型良性占位病变诊断准确率为 86.5 % ,明显高于CT检查 (70 .2 % ) ,Ρ <0 .0 1。结论 高场强MRI平扫与螺旋动态增强扫描对肾癌及肾内不典型占位病变的诊断价值较高 ,CT检查不能明确诊断时 ,高场强MRI是有效的补充检查手段。
Objective To compare the diagnostic value of high field MRI and spiral CT in the diagnosis of renal cell carcinoma. Methods Forty-seven cases of renal solid mass lesions including 34 cases of renal cell carcinoma, 4 cases of less or no-fat angiomyolipoma, 8 cases of complex cysts and 1 case of renal eosinophocytoma were examined by 1.5T MRI and spiral CT Plain and multi-phase dynamic enhanced examination, CT and MRI examination interval 2d ~ January. All cases were confirmed by surgical pathology. Results The sensitivity and accuracy of high field MRI in diagnosis of renal cell carcinoma were 97.1% and 89.4%, respectively, which were higher than the sensitivity and accuracy of spiral CT (91.2%, 83 .0%). The diagnostic accuracy of significant differences, Ρ <0. The diagnostic accuracy of MRI for atypical renal cell carcinoma, small renal cell carcinoma and atypical benign renal lesions was 86.5%, which was significantly higher than that of CT (70.2%), P <0.01. Conclusions High-field-intensity MRI and helical dynamic contrast-enhanced MRI are valuable in the diagnosis of atypical renal lesions and renal lesions. CT scan can not confirm the diagnosis, and high-field MRI is an effective supplementary test.