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目的探讨螺旋CT多期增强扫描对乳头状肾细胞癌(PRCC)的诊断及鉴别诊断价值。方法回顾性分析26例经手术病理证实的乳头状肾细胞癌的术前螺旋CT多期增强征像,并与手术病理结果对照分析。结果 PRCC的主要CT征象:平扫呈等低密度,增强扫描肿瘤呈较均匀或不均匀轻中度强化,少见液化坏死征象,可有假包膜;肾周间隙受侵征像有结节、条索状影、棘状突起和肾周筋膜增厚。结论螺旋CT多期增强扫描能较好的显示乳头状肾癌的影像特征,与肾透明细胞癌有明显不同,易于鉴别;CT多期增强扫描有助于与部分肾盂癌鉴别。
Objective To investigate the value of multi-phase helical CT in the diagnosis and differential diagnosis of papillary renal cell carcinoma (PRCC). Methods A retrospective analysis of 26 cases of pathologically confirmed papillary renal cell carcinoma by multi-phase spiral CT enhanced signs and surgical pathology results of controlled analysis. Results The main CT signs of PRCC were as follows: low density was observed on plain scan, and the tumors were uniformly or unevenly enhanced by enhanced scanning. Light and moderate enhancement was rare, and liquefied and necrotic signs were rare. There may be pseudocapsule; Bar-like shadow, spinous process and perirenal fascia thickening. Conclusions Spiral CT multi-phase contrast-enhanced MRI can show the imaging features of papillary renal cell carcinoma well, which is obviously different from that of renal clear cell carcinoma and easy to distinguish. CT multi-phase enhanced scan is helpful to distinguish with some renal pelvic carcinoma.