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[摘要] 目的 探討在对肾癌进行诊断时使用多层螺旋CT多期增强扫描的效果以及临床价值。方法 回顾性分析2017年6月—2019年6月时间内，方便选择的82例该院收治的肾癌患者，经过手术病理证实为肾癌，使用多层螺旋CT多期增强扫描对所有患者进行诊断，分析多层螺旋CT多期增强扫描的诊断准确率、对不同分期的符合率、不同亚型肾癌CT各期CT值比较，CT分型与病理细胞类型。 结果 多层螺旋CT多期增强扫描的诊断准确率96.34%与手术病理结果差异无统计学意义（χ2=3.060，P>0.05），对Ⅰ期87.5%、Ⅱ期96.30%、Ⅲ期100.00%、Ⅳ期100.00%的诊断符合率也与手术病理结果相似（P>0.05），不同亚型肾癌CT各期CT值比较差异有统计学意义（P<0.05），CT分型主要以局限外凸型为主，病理细胞类型主要以透明细胞型为主。 结论 在对肾癌进行诊断时使用多层螺旋CT多期增强扫描，诊断准确率较高，可以有效的对肾癌进行分期，与手术病理的结果差异较小，在诊断肾癌和分期上具有重要的意义，因此有临床推广的价值。

[关键词] 多层螺旋CT多期增强扫描;肾癌;分期;手术病理;亚型

[中图分类号] R737.11          [文献标识码] A          [文章编号] 1674-0742（2020）03（a）-0189-03

Analysis of Clinical Value of Multi-slice Spiral CT Multi-phase Enhanced Scanning in the Diagnosis of Renal Cancer

ZHUANG Shuai-guan

Department of Radiology， Quangang District Hospital， Quanzhou， Fujian Province， 362801 China

[Abstract] Objective To explore the effect and clinical value of multi-slice spiral CT multi-phase enhanced scanning in the diagnosis of renal cell carcinoma. Methods Retrospective analysis was performed from June 2017 to June 2019. 82 renal cancer patients admitted to the hospital were convenient selected and confirmed to be renal cancer through surgical pathology. All patients were diagnosed with multi-slice spiral CT multi-phase enhanced scanning. To analyze the diagnostic accuracy of multi-slice spiral CT multi-phase enhanced scanning， the coincidence rate for different stages， the comparison of CT values of different stages of different types of renal cell carcinoma CT， CT classification and pathological cell types. Results The diagnostic accuracy rate of multi-slice spiral CT multi-phase enhanced scan was 96.34% and there was no statistically significant between surgical and pathological results （χ2=3.060，P>0.05）. It was 87.5% in stage Ⅰ， 96.30% in stage Ⅱ， 10000% in stage Ⅲ， and 100.00% in stage Ⅳ. The diagnostic coincidence rate was also similar to the surgical pathological results （P>0.05）. The CT values of different stages of renal cancer in different subtypes have statistically significant differences （P<0.05）. The CT classification was mainly limited to the convex type. The pathological cell types were mainly clear cell types. Conclusion Multi-slice spiral CT multi-phase enhanced scanning is used in the diagnosis of renal cancer， and the diagnostic accuracy is higher. It can effectively stage renal cancer， and it has little difference with the results of surgical pathology. It is of great significance and therefore of clinical promotion value.

[Key words] Multi-slice spiral CT multiphase enhanced scan; Renal cancer; Staging; Surgical pathology; Subtype

随着社会老龄化、饮食结构的改变，不良生活习惯，家庭和社会压力大，以及吸烟、喝酒、遗传以及慢性疾病等使得肾癌的发病率越来越高，严重危害患者的生命健康。肾癌是起源于肾实质泌尿小管上皮系统的恶性肿瘤，也被叫做肾腺癌，临床主要的表现症状为腰疼和尿血，还会并发骨折，咯血等症状，主要分为Ⅰ、Ⅱ、Ⅲ、Ⅳ期[1]。临床对于肾癌的主要诊断方法有血常规检查、生化检查、肾功能检查、肝功能检查、尿常规检查、血清免疫学检查、X线拍片、腹部B超、CT、MRI、核素肾血流图、静脉尿路造影、组织病理学检查等[2]。以手术病理学诊断为金标准，且因其操作较复杂，无法作为早期诊断的主要方法。该研究回顾性分析2017年6月—2019年6月，对82例经过手术病理证实为肾癌的患者，探讨分析使用多层螺旋CT多期增强扫描的效果以及临床价值。