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目的分析肾占位性病变的CT表现,探讨CT对该类疾病的定性诊断价值。方法对手术/病例证实的28例肾占位性病变进行回顾性分析,所有病例均行平扫和增强扫描。结果肾恶性肿瘤21例(75%),其中肾癌(RCC)16例,CT表现为肾实质内形态不规则的低密度软组织肿块,增强后不强化或轻度强化;肾盂癌2例,CT表现为肾盂内软组织肿块影,增强后不强化或轻度强化。肾母细胞瘤(Wilms瘤)3例,CT表现为较大不规则的分叶肿块,增强后不强化;肾良性肿瘤3例(11%),均为肾血管平滑肌脂肪瘤(ALL),两例CT表现为多种不同成分的混杂密度肿块,一例表现为均匀等密度肿块,增强后软组织部分强化,而脂肪成分不强化。其它4例(14%),3例肾囊肿,CT表现为典型的边界清楚的囊性病灶,增强后未见强化;1例肾脓肿,CT表现为实质性与囊性混杂密度的肿块,增强后实质性部分有轻度强化,囊性部分不强化。结论CT平扫及增强扫描,以及诊断过程中密切结合病史,对肾占位性病变有重要的鉴别诊断价值。
Objective To analyze the CT manifestations of renal space-occupying lesions and to explore the value of CT in the qualitative diagnosis of such diseases. Methods A retrospective analysis was performed on 28 cases of renal space-occupying lesions confirmed by operation / case analysis. All patients underwent plain scan and contrast-enhanced scan. Results Twenty-one cases (75%) of renal malignant tumors, of which 16 cases were renal cell carcinoma (RCC). The CT findings were irregular low-density soft tissue masses in renal parenchyma, which were not enhanced or mildly enhanced. The performance of renal pelvis mass of soft tissue shadow, enhanced or not after strengthening. Wilms tumor in 3 cases, CT showed large irregular lobulation mass, enhanced without enhancement; 3 cases of benign neoplastic tumors (11%), all of the renal angiomyolipoma (ALL), two Cases of CT showed a variety of different components of the mixed density lumps, one case showed uniform isodense lumps, enhanced soft tissue partially enhanced, while the fat composition is not enhanced. The other 4 cases (14%), 3 cases of renal cysts, CT showed a typical cystic lesions of the clear boundary enhanced without enhancement; 1 case of renal abscess, CT showed substantial and cystic mixed density of the mass, enhanced Substantial part of mild enhancement, cystic part is not enhanced. Conclusion CT scan and enhanced scan, as well as the close combination of medical history during the diagnosis of renal space-occupying lesions have important differential diagnosis value.