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目的分析肾细胞癌不同亚型影像学特点,提高诊断水平。方法对37例肾细胞癌(其中透明细胞癌29例、乳头状癌7例、嫌色细胞癌1例)的 B 超、CT、MRI 影像学差异进行比较分析。结果 32例实性肾癌 B 超示:透明细胞癌多表现为低回声(20/26),乳头状癌多为等或弱强回声(4/5),嫌色细胞癌呈中强回声,透明细胞癌与非透明细胞癌差异有统计学意义(P=0.005)。29例实性肾癌行 CT 检查:透明细胞癌(23例)和非透明细胞癌(6例)平扫均显示软组织密度影,但强化后透明细胞癌表现出明显的不均匀强化,增强幅度明显高于非透明细胞癌(P=0.004)。17例实性肾癌行 MRI 检查,透明细胞癌 T2WI 多为高信号(10/11),与乳头状癌的 T2WI 等/低信号(5/5)比较差异有统计学意义(P<0.01)。结论综合术前 B 超、CT、MRI 影像学检查结果,有助于肾细胞癌亚型的术前诊断。
Objective To analyze the imaging features of different subtypes of renal cell carcinoma and to improve the diagnostic level. Methods Thirty-seven cases of renal cell carcinoma (including 29 cases of clear cell carcinoma, 7 cases of papillary carcinoma and 1 case of chromophobe carcinoma) were analyzed by B-ultrasound, CT and MRI. Results 32 cases of solid renal cell carcinoma B ultrasound showed: clear cell carcinoma showed hypoechoic (20/26), papillary carcinoma mostly equal or weak strong echoes (4/5), chromophobe carcinoma showed moderate echoes, The difference between clear cell carcinoma and non-clear cell carcinoma was statistically significant (P = 0.005). 29 cases of solid renal cell carcinoma underwent CT examination: clear cell carcinoma (23 cases) and non-clear cell carcinoma (6 cases) showed soft tissue density scan, but after clear cell carcinoma showed clear heterogeneous enhancement, enhancement Significantly higher than non-clear cell carcinoma (P = 0.004). In 17 cases of solid renal cell carcinoma, T2WI of clear cell carcinoma was mostly high signal (10/11) and T2WI / low signal (5/5) of papillary carcinoma were statistically significant (P <0.01) . Conclusion The preoperative B-ultrasound, CT, MRI imaging findings, contribute to the preoperative diagnosis of renal cell carcinoma subtypes.