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目的:探讨肾细胞癌螺旋CT动态扫描检测及定性肿瘤的优化时间窗。方法:24例病理证实的肾细胞癌经平扫选定病灶靶平面后静脉注射造影剂,延迟14～17秒开始作靶平面增强同层动态扫描,扫描间隔4.9秒,共扫描17～24帧。随后行包括全肾的肾实质期扫描及靶平面单层延迟扫描(排泄期)。在统一标准下明确肾脏各期开始的层面及延迟时间以及肿瘤征象显示最早和最佳层面及延迟时间。明确肿瘤、肾皮质、肾髓质及腹主动脉的峰值及峰值到达时间,并计算每一例肿瘤与肾皮质、肾髓质CT值最大差值。并按肿瘤实质时间-密度曲线的升段斜率的大小分为3型。结果:肾细胞癌CT征象显示最佳时间为70.2秒,最早显示征象时间为23.9秒。肾细胞癌峰值到达时间及峰值分别为54秒及80.4hu。肿瘤与肾实质最大密度差值时间分布于曲线末102秒,占100%。结论:对肾细胞癌患者作病灶靶层面同层动态扫描(扫描时间为24、38、70秒、100秒)加全肾螺旋扫描,或根据需要在同层面加作一层延迟扫描(延迟时间视不同目的而定)可获得比较丰富和全面的检测及定性的诊断信息。
Objective: To investigate the dynamic CT scan of renal cell carcinoma and optimize the time window of qualitative tumor. Methods: Twenty-four cases of pathologically confirmed renal cell carcinoma were injected with contrast agent through the posterior plane of the selected target lesion. After a delay of 14 to 17 seconds, the target plane enhanced dynamic scanning of the same layer was performed. The scanning interval was 4.9 seconds and the total scanning time was 17 to 24 frames . Subsequent lines included whole-kidney renal parenchymal and target flat-bed delayed scanning (excretory phase). In a unified standard to clearly the beginning of the various stages of the kidney and the delay and tumor signs showed the earliest and the best level and delay time. Clear tumor, renal cortex, medulla and abdominal aorta peak and peak arrival time, and calculate each case of tumor and renal cortex, medullary CT value of the maximum difference. And according to the size of the slope of the rising segment of the tumor parenchymal time-density curve, the type was divided into three types. Results: The CT signs of renal cell carcinoma showed the best time was 70.2 seconds, the earliest showed signs of time was 23.9 seconds. Renal cell carcinoma peak arrival time and peak were 54 seconds and 80.4hu. Tumor and renal parenchyma maximum density difference in the time distribution of 102 seconds at the end of the curve, accounting for 100%. Conclusions: Whole-cell spiral scans of patients with renal cell carcinoma at the same target (24, 38, 70, 100 seconds) at the target level of the lesion, or with a delayed scan at the same level as required (delay time Depending on the purpose) can get more comprehensive and comprehensive diagnostic test and qualitative information.