目的探讨超声与CT对囊性肾细胞癌(cysticrenal cell carcinoma,CRCC)的临床诊断价值。方法回顾性研究3l例CRCC的超声和CT表现,并与病理检查结果行对照研究。对超声和CT的正确诊断率进行统计学分析。结果31例CRCC中,单囊型12例,共13个病灶。其中,伴壁结节者9个,伴有分隔者10个。超声检查4例囊腔内呈无回声,CT平扫呈均匀低密度;8例呈漂浮低回声,CT平扫囊腔内呈混杂低密度;囊壁结节和囊间隔超声检查见丰富血流信号,CT增强扫描呈明显强化。多囊型19例,共20个病灶。伴壁结节者8个,伴有分隔者13个。超声与CT检查可见多个囊腔,壁结节与囊壁内可见短棒状血流信号,CT可见明显强化。超声与CT诊断CRCC正确率分别为64.52%、58.06%.两者差异无统计学意义。超声结合CT诊断正确率为90.32%,高于单纯超声及CT检查,差异有统计学意义。结论CRCC的超声及CT表现具备一定特征性,认识其影像学特征对减少误诊具有重要意义,联合采用2种影像学检查方法有助于提高本病检出率。
Objective To investigate the value of ultrasound and CT in diagnosing cystic renal cell carcinoma(CRCC). Methods Ultrasonic and CT findings of CRCC in 31 cases confirmed by pathology were retrospectively studied. The correct diagnostic rates of CRCC by ultrasound and CT examination were statistically analyzed. Results Of 31 patients with CRCC, the lesions(13) in 12 patients were unicystic, among which there were 9 with mural nodule and 10 with septum. Four unicystic lesions demonstrated fluid eeholess in the cyst at uhrasonography and homogeneous low intensity at CT. Eight unicystic lesions revealed floating hypoecho in the cyst at ultrasonography and inhomogeneous low intensity at CT. In unicystic lesions, plentiful blood signal was detected in the mural nodule and septum by ultrasonic examination,and demonstrated obvious enhancement on CT images. 20 lesions in 19 patients were polycystic, mural nodules in 8 and septum in 13 cases were found respectively. Multiple cysts were revealed by ultrasound and CT ex- amination in all polycystic CRCC. The mural nodule and cystic wall showed short-bar shape blood flow signals at ultrasonography and markedly enhancement at contrast-enhanced CT. The positive rates of diagnosis of CRCC with ultrasound and CT were 64.52% and 58.06%, respectively,there was no statistical difference between them. The positive rate of diagnosis of CRCC with combining ul- trasound and CT examiantion was 90.32%, which was significantly higher than that with ultrasonography or CT examination alone. Conclusion CRCC demonstrates certain characteristic imaging signs at identify these imaging features in order to reduce the misdiagnosis. improve the detection rate of CRCC. ultrasound and CT examination. It is important to correctly Combination of ultrasonography and CT examination will help to