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1、UrinarySystemCollegeofRadiologyTaishanMedicalUniversityLUChuanRenalcellcarcinomaRenalcellcarcinomaRenalcellcarcinoma(RCC)isthemostcommonrenaltumor,comprisingapproximately85%ofallprimarymalignantrenalneoplasms.Renaltumorsareusuallysolitary,althoughbilater
2、altumorsareencounteredinapproximately2%ofpatients.RCCoccursmainlyinthesixthdecade;theyhavebeenfoundinchildren,butonlysporadically偶发的.Thedevelopmentisnotrelatedtoethnicgroups人种.Histologically,themostcommontypeofmalignantrenalcellcancerisclearcelladenocarc
3、inoma透明细胞腺癌,withgranular颗粒的cellcarcinomanextinfrequency.其次是Papillary乳头状的tubularadenocarcinomadefinesasmallgroupofRCC,butbecauseoftheirlimitedbloodsupply,thesecansimulatecysticlesionsand,thus,canrepresentadiagnosticchallengeonimaging.RCCarisesfromtheproxi
4、malconvoluted卷曲的tubule.肾曲小管RCCsarerelativelyslowgrowingandmaybelargebeforetheyproducesymptoms.Beforewidespreaduseof广泛使用cross-sectionalimaging(US,CT,MRI),renalcellcanceroftenpresentedasanadvanceddiseaseatthetimeofdiagnosis在就诊时.Today,however,therehasbeenas
5、hifttoasmallersizeandlowerstageofrenalcellcanceratthetimeofdiagnosis.RCCmaybelocallyaggressive侵略的,攻击性的,extendinginto扩散到therenalveinsandinferiorvenacava(IVC)orinvadingadjacentsofttissuestructures.RCCcanmetastasizebylymphaticandhaematogenousroutes.通过淋巴和血行转
6、移Commonsitesofhaematogenousmetastasesincludebone,liver,andlungs.Nodalmetastasescommonlyinvolvepararenalandpara-aorticnodesandmayalsoincludemediastinalandpulmonaryhilarnodes.Imagingplaysanimportantpartinthedetection,characterizationandstaging疾病分期,肿瘤分类ofre
7、nalcellcancer.Althoughtheintravenousurogram尿路照片(IVU)isstilloftenusedastheinitialstudyinthesearchforrenalmasses,ithasbeenshownthat已经显示inthepresenceofaCT-confirmedrenalmass,detectionbyIVUisonly21%whenthelesionissmallerthan2cm,52%whenthelesionis2~3cm,and85%
8、whenthelesionis3cmormoreindiameter.AnormalIVU,therefore,doesnotexcludethepresenceofarenalmass.WhileUSisanexcellentmodalityforthedetectionandcharacterizationofrenalcysts,inthedetectionofsolidlesionsUSaccuracydecreasesconsid
