薄层CT图像在肾癌诊断及分期中价值.docVIP

薄层CT图像在肾癌诊断及分期中价值[摘要] 目的:探讨薄层(1.5 mm)螺旋CT图像在肾癌术前诊断和分期中的价值。方法:选择32例经手术病理证实为肾癌的病例,将其薄层CT图像和常规层厚CT图像与病理结果进行回顾性对比分析。结果:常规层厚CT图像组术前CT分期正确率为75.0%。薄层CT图像组术前CT分期正确率为90.6%。薄层图像对于肾癌分期及肾癌内组织性质的判断更加准确。结论:薄层CT图像能更加清楚地显示肾癌的组织、大小、范围及淋巴、肾筋膜囊及周围脏器受累情况,并且用于术前诊断及分期较常规图像更加准确。 [关键词] 肾脏肿瘤;计算机体层摄影术诊断;分期 [中图分类号] R445.3 [文献标识码]B [文章编号]1673-7210(2010)05(b)-079-02 The value of thin helical CT images in the diagnosis and stages of kidney cancer ZHANG Xiaojuan, MU Hong, XU Huayu, ZHAO Chengshuang, LI Zhen (Medical Imaging Center, the Third People’s Hospital of Liaoyang City, Liaoyang 111000, China) [Abstract] Objective: To discuss the value of thin helical CT images (1.5 mm) in the preoperative diagnosis and stages of kidney cancer. Methods: 32 cases of kidney cancers confirmed by operation were selected, their thin-layer CT images, conventional CT images and pathological results were retrospectively analyzed. Results: The accuracy of preoperative CT stages of conventional CT images group was 75.0%, that of thin-layer CT images group was 90.6%. Thin-layer CT images’ was more accurate in the stages and diagnosis of features of kidney cancer. Conclusion: Thin-layer CT images can show the kidney cancer’s organization, size, scope, the lymph, the renal fascia capsule and the involvements of peripheral organs more clearly, and it is more accurate in the preoperative diagnosis and stages than the conventional CT images. [Key words] Kidney cancer; Computed tomography diagnosis; Stage 肾癌是肾实质肿瘤中最常见的一种,其发病率在泌尿系统肿瘤中占第二位,仅次于膀胱癌,占成人肾恶性肿瘤的80%～85%。肾癌的CT诊断分期对于肾癌治疗及预后有重要意义。本文收集我院2005年1月～2009年12月经手术病理证实的32例肾癌患者的临床资料和CT图像(PACS中调用),并与病理诊断分期进行比较,分析不同层厚CT图像对肾癌的诊断与分期的准确性。 1 资料与方法 1.1 一般资料 肾癌患者32例,男18例,女14例;年龄31～65岁,平均55岁。所有病例术前接受CT平扫及增强扫描,随后接受手术治疗及术后病理检查。病理结果:肾透明细胞癌18例,乳头状肾细胞癌9例,肾嫌色细胞癌5例。临床表现:无痛性肉眼血尿15例,腰痛11例,无任何症状体检发现3例,发热3例。 1.2 检查方法 采用西门子公司64层螺旋CT扫描机,自肾上腺至肾下极轴位平扫,扫描层厚、层间距均为5 mm,螺距为0.98。平扫及增强图像均重建为层厚0.5 mm,层间距0.5 mm,图像传送到PACS保存。使用德国双路高压注射器经肘静脉注入非离子造影剂碘帕醇(370 mg/ml),造影剂对比剂量为60～