螺旋CT增强扫描对小肾癌诊断价值.docVIP

螺旋CT增强扫描对小肾癌诊断价值【摘要】 目的 探讨小肾癌的CT表现,分析其影像特征,评价螺旋CT增强扫描对小肾癌的诊断价值。方法 回顾分析35例经手术病理证实的小肾癌CT表现,35例均行CT平扫及动态增强扫描,增强扫皮质、实质及肾盂排泄三期。结果 平扫等密度11,稍低密度24例,密度均匀或不均匀,增强扫描30例表现为皮质期明显强化,实质期强化减弱,肾盂期更低,肿瘤强化呈“快进快出”特点。5例动脉期轻-中度强化,实质期强化减弱,肾盂期更低。 结论 小肾癌的CT表现有一定特征性,螺旋CT增强扫描对小肾癌的检出率较高,对小肾癌的诊断和鉴别诊断有很大价值。 CT Diagnosis of small renal carcinoma 【Abstract】 Objective To analyze the CT mannifestations of small renal carcinoma and to evaluate the role of spirl CT SRCC.Methods 35 cases of small renal carcinoma proved by surgery and pathology were examined by spirl CT scan and enhancement.The spirl enhancement manifestations included corticographic phase.nephrographic phase,and pyelographic phase.Results In 35 case,the lesions were isodense in 11 cases,slighly hypodense in 24 cases,after contrast scan all of them had marked enhancement.the CT manifestations is preseted 30 cases enhanced obviously in corticomedullary phase.And then decreased in attenuation during nephrographic phase,and even down in pyelographic phase.3 cases enhanced slightly in corticomedullary phase.and then decreased in attenuation during nephrographic phase.Conclusion The CT finding in small renal carcinoma have some characteristic feature,the spirl CT can improved the acurate rate of diagnosis. 【Key words】Kidney neoplasms;Tomography;X-ray computered 作者单位:638500四川省邻水县人民医院 小肾癌是直径≤3 cm的肿瘤,因为病灶小,常规检查易漏检,鉴别诊断也有一定困难,随着近年来螺旋CT的广泛运用,大大提高了小肾癌的检出率和定性诊断论力,为小肾癌早期诊断,及时手术赢得了时间,提高了患者的生成率。笔者通过15例经手术病理证实为小肾癌的影像进行系统分析,旨在提高对它的认识。 1 资料与方法 35例患者,男23例,女12例,年龄47~76岁,平均59.4岁,均无血尿及腰痛临床症状,为体检或其他疾病就诊时发现,所有病例均行螺旋CT平扫及增强扫描,后经手术病理证实的小肾癌。 CT扫描采用日本东芝双排螺旋CT机,120 KV,100-120 MAs,层厚5 mm,螺距1.0,行无间隔扫描,对病变区行薄层动态扫描,增强用高压注射器经肘静脉注入浓度为300 ngl/ml非离子造影剂100 ml,3 ml/s速率,注射对比剂后30~40 s开始皮质期扫描,70~120 s实质期扫描,2~3 min后肾盂期扫描。 2 结果 小肾癌CT平扫表现:35例均为圆形或椭圆形,边界清楚,位于肾皮质内或皮髓质交界区,大部分肾形态无改变,部分突出于肾轮廓外,等密度者11例,稍低密度者24例,CT值范围31~45 HU,平均39 HU,3例有钙化,1例有囊变,大部分边界清楚,周围有包假膜。 CT增强表现:30例患者增强皮质期明显强化,CT值明显迅速上升,较平扫增强40~101 HU,平均升高53 HU,均高于或等于肾皮质,强化均匀或不均匀;实质期强化减弱,平均减低40