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目的 :探讨肾细胞癌术前 CT分期的方法 ,提高肾细胞癌 CT分期的准确率。方法 :5 6例肾细胞癌均经手术病理证实 ,用盲法根据 CT征象判断肾包膜、肾静脉和下腔静脉、区域淋巴结及邻近器官组织的侵犯情况 ,并按 Robson分期法进行 CT分期 ,将手术病理结果与 CT分期进行对照研究。结果 :CT判断肾包膜侵犯的敏感性为 82 % ,特异性为 85 % ;静脉侵犯的敏感性 80 % ,特异性 93% ;区域淋巴结转移敏感性 91% ,特异性 88% ;邻近器官组织侵犯敏感性 86 % ,特异性 97%。 CT分期与手术病理分期总体符合率为 91%。结论 :CT是肾细胞癌术前分期的有效方法。采用薄层、动态扫描、仔细观察 CT征象 ,结合 MRI及超声检查 ,能提高肾细胞癌术前 CT分期的准确率
Objective: To explore the method of preoperative CT staging of renal cell carcinoma and to improve the accuracy of CT staging of renal cell carcinoma. Methods: Fifty-six patients with renal cell carcinoma were confirmed by surgery and pathology. The renal capsule, renal veins, inferior vena cava, regional lymph nodes and adjacent organs were evaluated by blinded method according to CT findings. CT staging was performed by Robson staging , The surgical pathological results and CT staging for controlled study. Results: The sensitivity and specificity of CT in predicting nephritis were 82% and 85% respectively. The sensitivity and specificity of venous invasion were 80% and 93% respectively. The sensitivity and specificity of regional lymph node metastasis were 91% and 88% respectively. The adjacent organs and tissues Violation of sensitivity 86%, specificity 97%. The overall coincidence rate of CT staging and surgical pathology staging was 91%. Conclusion: CT is an effective method for preoperative staging of renal cell carcinoma. Thin layer, dynamic scanning, careful observation of CT signs, combined with MRI and ultrasound, can improve the accuracy of preoperative CT staging of renal cell carcinoma