侯俊 丁长青　罗慧　王宗磊

[摘要] 目的 探讨多排螺旋CT（MSCT）在肾细胞癌诊断中的应用价值。 方法 回顾性分析2013年10月～2017年3月在我院行MSCT检查并经手术病理证实的43例肾癌患者资料，重点分析其MSCT平扫及多期增强特征。结果 本组均为单发病灶，其中肿瘤位于左肾21例、右肾22例，肿瘤呈圆形或类圆形29例，不规则形14例。直径：1.5～14.3 cm，平均（4.7±1.6）cm。CT平扫表现为肾实质混杂密度或等密度占位病变，瘤体与肾实质分界不清，CT增强多呈速升速降型。 结论 MSCT尤其是增强可对肾细胞癌作出诊断，值得应用。

[关键词] 肾细胞癌；多排螺旋CT；增强扫描；诊断

[中图分类号] R692 [文献标识码] B [文章编号] 1673-9701（2018）10-0116-05

Application of MSCT in diagnosis of renal cell carcinoma

HOU Jun1 DING Changqing2 LUO Hui2 WANG Zonglei1

1.Department of Urology， Fengxian People's Hospital in Jiangsu Province， Fengxian 221700，China；2.Department of Imaging， Fengxian People's Hospital in Jiangsu Province， Fengxian 221700，China

[Abstract] Objective To investigate the value of multi-slice spiral CT （MSCT） in the diagnosis of renal cell carcinoma. Methods From October 2013 to March 2017 in our hospital，43 patients with renal cell carcinoma confirmed by MSCT were enrolled.The data especially the characteristics of plan scan in MSCT and its multi-phase enhancement were analyzed emphatically. Results All were unilateral lesion，which located in the left kidney in 21 cases and located in the right kidney in 22 cases. The tumors were round or oval in 29 cases and irregular in 14 cases ranging from 1.5 cm to 14.3 cm，average（4.7±1.6）cm in diameter. CT scan showed renal parenchymal lesion with mixed density or isodensity with unclear boundarie. Mostly enhanced CT presented as rapidly increasing initially and decreasing rapidly. Conclusion MSCT， especially its enhanced scan can diagnose renal cell carcinoma， so which is worthy of application.

[Key words] Renal carcinoma； Multi-slice spiral CT； Enhanced scan；Diagnosis

腎细胞癌（renal cell carcinoma，RCC）为成人肾脏最为常见的恶性肿瘤，其起源于泌尿小管上皮系统，以50～70岁的男性最为多见。本症早期多无明显的临床症状、发现时多较晚，成为预后较差的主要原因。随着多排螺旋CT（multi-slice spiral CT，MSCT）的渐趋普及，其快速成像、多期增强扫描及其多层面后处理的优势，优于传统的彩超及静脉肾盂造影，在肾癌诊断及鉴别诊断中具有重要价值[1]。本文现回顾性分析我院收治的43例RCC患者资料，重点分析其MSCT平扫及多期增强特征，并复习相关文献，以期提高认识。

1 资料与方法

1.1 临床资料

2013年10月～2017年3月在我院行MSCT检查，并经手术病理证实的43例RCC患者中，男30例，女13例，年龄42～81岁，平均（67.26±2.71）岁。入院时主要表现：腰肋三角区不适30例，血尿36例，腹部扪及肿块4例，5例无自觉症状，为彩超或CT体检发现。纳入标准：入组病例均在本院行MSCT检查、并经本院或外院手术病理证实为肾细胞癌。……