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目的 探讨不同亚型肾癌的CT特征,评估CT增强扫描在其诊断中的应用价值.方法 回顾性分析112例经手术及术后病理证实肾癌患者的CT资料,其中透明细胞癌86例,乳头状肾细胞癌13例,嫌色细胞癌13例,观察其影像学特征及三期增强CT值,并与病理结果进行对照分析.结果 三种肾癌的平扫CT值差异无统计学意义.三期增强中,透明细胞癌均比乳头状肾细胞癌和嫌色细胞癌强化明显,差异有统计学意义(P<0.01),以皮质期最为显著.乳头状肾细胞癌和嫌色细胞癌的各期强化值差异无统计学意义.透明细胞癌出现不均匀强化的概率(87.2％)明显高于乳头状肾细胞癌(46.2％)和嫌色细胞癌(53.8％),差异有统计学意义(P<0.05).透明细胞癌发生坏死或囊变的概率高于乳头状肾细胞癌和嫌色细胞癌.嫌色细胞癌出现钙化的概率高于透明细胞癌和乳头状肾细胞癌.结论 肾癌不同亚型之间的CT表现及增强扫描存在差异,CT三期增强扫描能为肾癌的诊断和鉴别诊断提供重要指导价值.“,”Objective To explore the CT features of different subtypes of renal cell carcinoma (RCC) and evaluate the application value of CT enhanced scan in diagnosis of RCC. Methods CT imaging data of 112 patients with renal cell carcinoma confirmed by surgery and biopsy in our hospital were analyzed retrospectively. There were 86 cases clear cell carcinoma, 13 cases papillary renal cell carcinoma and 13 cases chromophobe cell tumor. The CT imaging features and three phase CT enhanced values were observed comparing with pathological diagnose results. Results CT value on unenhanced scan was not statistically different. CT value of clear cell carcinoma was higher than that of papillary and chromophobe RCC in three phases (P value < 0.01 respectively), especially for the cortical phase. However that of papillary and chromophobe RCC was not statistically different in every phases. The percentage of homogeneous enhancement in clear cell carcinoma patients was 87.2％, which was significantly higher than papillary RCC (46.2％) and chromophobe RCC (53.8％) and there are statistical difference (P<0.05). The incidence of necrosis and cystic degeneration in clear cell carcinoma patients were significantly higher than the papillary RCC and chromophobe RCC, while the incidence of calcification in chromophobe RCC were higher than clear cell carcinoma and papillary RCC. Conclusion There are some differences in CT features and enhanced scan of different subtypes of RCC. Three-phase CT enhanced scan can provide important guiding values for the diagnosis and therapy of RCC.