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目的探讨螺旋CT多期动态增强扫描在诊断小肾癌中的价值。方法回顾性分析49例经手术或活检病理证实的小肾癌平扫及三期(皮质期、实质期、肾盂期)增强扫描征象,进行分析并寻找其特征性征象,并与超声结果对照。所有病例均先行超声检查。结果49例共53个病灶,其中小实性肾癌43例47个,增强扫描皮质期35个呈明显强化,12个呈轻中度强化;小囊性肾癌6例6个,增强后皮质期囊壁、壁结节、囊内分隔明显强化。实质期及肾盂期强化迅速减退,呈快进快退改变。CT检出敏感性100%,诊断准确性91%;超声对小肾癌的检出率为96.3%,但准确性仅为38.6%。结论螺旋CT多期增强动态扫描可明显提高小肾癌的诊断准确率,定性诊断较超声更具优势。
Objective To investigate the value of spiral CT multi-phase dynamic contrast-enhanced scanning in the diagnosis of small renal cell carcinoma. Methods A retrospective analysis of 49 cases of small renal cell carcinoma confirmed by surgery or biopsy pathology and three stages of enhanced scanning (cortical, parenchymal, pelvis) enhanced scan were analyzed and find the characteristic signs, and compared with the ultrasound results. All cases were preceded by ultrasound. Results A total of 49 lesions were found in 49 cases, of which 43 cases were small solid renal cell carcinoma, 47 cases were significantly enhanced in scanning cortical phase, 12 were mild to moderate enhancement, 6 cases were small cystic renal cell carcinoma with enhanced cortical Periodic wall, wall nodules, cystic separation was significantly enhanced. Essence and renal pelvic strengthening rapid decline, was fast forward rewind change. CT detection sensitivity of 100%, diagnostic accuracy of 91%; ultrasound detection of small renal cell carcinoma was 96.3%, but the accuracy was only 38.6%. Conclusion Spiral CT multi-phase enhanced dynamic scanning can significantly improve the diagnostic accuracy of small renal cell carcinoma, qualitative diagnosis more advantages than ultrasound.