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1、中国医学计算机成像杂志1998年第4卷第4期-245-肾脏肿瘤的CT诊断王志成徐博良周正荣沈天真目的:分析肾脏良恶性肿瘤的CT表现,探讨CT对该类疾病的诊断价值。材料和方法:对手术和病理证实的104例肾脏肿瘤进行回顾性分析,所有病例均行平扫和增强。结果:104例中,良性肿瘤6例(占5.8%),均为肾血管平滑肌脂肪瘤(ALL),CT表现为肾实质内含多种不同成分的混杂密度肿块,可有分房、分隔,内含脂肪是其特征性表现,增强后软组织部分强化,而脂肪区无强化。恶性肿瘤98例(占94.2%),其中肾细胞癌(RCC)82例,CT表现为肾实质内形态不规则、边界
2、欠清的低密度软组织块影,动态增强后可见一过性强化。应用动态薄层增强CT扫描法准确检出小肾癌(最大径<3cm)8例,该法为目前检查小肾癌的最佳影像方法。肾盂癌11例(均为移行细胞癌),CT表现为肾盂内分叶状低密度软组织块影,增强后病灶强化不明显。肾母细胞瘤(Wilms瘤)5例,均为4岁(平均2.5岁)以下小儿,CT表现为肾实质部位较大的不规则较低密度软组织块影,增强后无明显强化。结论:增强前后CT扫描对肾脏肿瘤的定位、定性诊断及术前分期均具有十分重要的价值。关键词肾肿瘤CTComputedTomographicDiagnosisofRenalNe
3、oplasmsWangZhicheng,XuBoliang,ZhouZhengrong,etal.DepartmentofRadiology,CentralHospitalofJinshanDistrict,Shanghai201500Purpose:ToanalysetheCTfindingsofbenignandmalignanttumorsofthekidneyandtoinvestigatethevalueofCTimagingindiagnosingthesediseases.MeterialsandMethods:104caseso
4、frenaltumors,provensurgicallyandpathologically,wereretrospectivelyreviewed.Pre-andpost-contrastCTscanswereperformedinallthepatients.Results:6of104cases(5.8%)ofbenigntumorswereangioleiomy-olipoma(ALL).CTshowedamixeddensitytumorofvariouscomponentswithloculationandseptaintheren
5、alparenchyma,thecharacteristicimagingfeaturewastheinclusionoffat.Thesofttissuepartofthetumorshowedenhancementnevertheless.Theareaoffatdidnotshowanyenhancementofthecontrastmedium.98of104cases(94.2%)weremalignanttumorswith82casesofrenalcellcarcinoma(RCC)showingasirregular-shap
6、edlowdensitysofttissuemasswithill-definedmarginandtransienten-hancementonCTscans.8smallrenalcellcarcinoma(<3cmindiameter)weredetectedbymeansofdy-namicthin-sectioncontrastenhancement.11of98caseswerecarcinomaoftherenalpelvis(Allweretransitionalcellcarcinoma)lobucatedlowdensity
7、softtissuemassoftherenalpelviswithnosignificantenhancement.5of98caseswerechildren(youngerthan4yearsold,mean2.5yearsold)withnephrob-lastoma(Wilms'tumor)appearingaslargerirregularlowerdensitysofttissuemassoftherenalparenchymawithnosignificantenhancement.Conclusion:Pre-andpost-
8、contrastCTscansplayindis-pensablerolesinthelocalization,qualitation,andgrad
