| Part l. Study of Diaguostic Imaging and ComParison with Pathology in renal cellcarrInomaPurpose: Using statistical analysis resu1ts of diagnostic images in cases with renal cellcarcinoma ocC) comParison with that of SUrgery and pathOlOgy tO eva1uate: l. the valUe ofdifferent imaging examinations for the aPplication and diagnosis in RCC. 2. the signficanceof differellt imaging exarninations in the preoperative staging of RCC. 3. the valuation ofspiral CT in examination of RCC. 4. the correlation for CT findings with histopathologicfeatures in RCC.Materials and Methods: Total 1l9 cases with RCC proven by surgery and pathOlogyhad been reviewed and studied retrospectively, including 77 men and 42 women, with meanages 53.99 l 13.47 years old. KLJ'B and IVP were performed in 98 cases, CT with pre- andafter-contrast examined in 93 cases, MR examined in l7 cases, UltrasonograPhy examined in105 cases, and DSA examined in 25 cases. The clinic characteristics and various imagingfeatues of RCC were analyzed statistica11y and comPared with surgical and patholOgicalresults. The statistical methods included t-test, U-test, X'-test, RxC relation ana1ysis, ct al.Results: l. The male incidence of RCC was higher than female, with male: female aboul 1.83:l.The ages of 85.71% cases were above 40 years old. 48.74% cases were diagnosed incidentally in a routineexamination. The main syInPtoms were lumbago and hematuria, and 62.5% hemdsriae were intendttentand painless. 2. 66.39% RCC were clear cell carcinomas. 93.28% tumprs possessed envelOPe in differentextent. 73.1l% cases belonged to the stage of I and II. 3. KUB and fVP didn't show any abnonnalsigns in 58.16% and 23.47% cases respectively The tUmor sizes of tWo grouPs with or without abnrmalsigns in lVP were significantly discrepam (P<0.01). 4. 90.32% lesions shown medium or obviousenhancement on contrasted CT scanning. 77.42% lesions were divided into tyPe of local protrUsion on CTclassification. The proportion of small and cystic RCC was l1.83% respectively The degree ofenhancement of lesions on contrast CT was quite correlated to the modal of malignan cells ranking. Theshort-hair sign surround the marin of tUmor was strongly imPly renal envelope aggheved (P<0.0l). Thediagnostic accuracy for RCC by CT was 91.40%. The staging with CT was quite positively correlatCd tothat with surgery and pathology (PO.01). 5. MRI could display the lesion clearly, especially for the vein involvement. The diagnostic accuracy of the tumor by MRI was 91.40%. The staging with MRI was also quite positively correlated'to that with surgery and pathology (PO.01). 6. Of the 25 cases examined with DSA, the lesions shown high blood supply in 11 cases, medium blood supply in 6 cases and low supply 8 cases. The tumor vessels and dyeing signs could be found in all cases. The diagnostic accuracy of the tumor by DSA was 96%. 7. US could find lesions in all cases, most of lesions displayed with mixed echo. The diagnostic accuracy of the tumor by US was 87.62%.Conclusions: 1. RCC was dominant to be found in the man with age over 40 years old. About half of the cases were accidentally diagnosed without any symptoms and most of the tumors were clear cell carcinomas with envelopes. 2. hi the imaging examinations of RCC, IVP could indirectly display tumor sign, so the diagnostic value for RCC was limited. US should be the first examining choice for its simple operation, cheap price and some diagnostic value. Not only direct display of internal and around structures of tumors, but also appropriate staging of them, either of CT or MRI should be a routine method in the examination of RCC. DSA could directly display tumor vessels and had high value in differentiation of malignant and benign tumor, but as a traumatic examination it seldom used for the aim of diagnosis, only before embolization therapy. 3. With rapid acquisition times and thin slice reconstructions, spiral CT could obtain more clearly enhanced images and show better character...
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