| Objective: By using statistical analysis results of diagnostic CT images in patients with renal cell carcinoma(RCC)comparison with that of surgery and pathology, to evaluate: 1. the value of CT imaging examinations for the application an diagnosis in RCC. 2. the significance of CT imaging examinations in the preoperative staging of RCC.(the new modification staging in 1997 and 2002) 3. the correlation of CT findings with histopathologic features in RCC. Methods: Total 55 cases proven by surgery and pathology had been reviewed and studied retrospectively. The clinic characteristics and CT imaging features of RCC were analyzed statistically and compared with surgical and pathological results. The statistical methods included t-test, chi-squared test, etc. Results: 1. The incidence of RCC in male group was higher than female,with male:female about 1.89:1.The ages of 87.69% cases were above 40 years old. 48% cases were diagnosed incidentally in a routine examination or without symptoms. The main symptoms were lumbago and hematuria, and 53.3% hematuria were intermittent ,directly visible and painless. 2. 76.36% RCC were clear cell carcinomas,90.91% tumors possed envelope indifferent lesions shown medium or obvious enhancement on CT scanning. 3. 76.36% lesions were divided into type of local protrusion on CT classification. The proportion of small and cystic RCC was 10.90% respectively. The short-hair sign surround the margin of tumor on CT scanning was presented in 17 cases , in which there were 14 cases renal envelopes invaded in pathology,the relation between them was apparent(p<0.01).4. The margin of tumor on CT scanning was clear that had not divided the leaf in 25 cases,when 22 patients had complete envelope in pathology, the relation between them was apparent (p<0.01) . Conclusions: 1. With rapid acquisition times and thin slice reconstructions, spiral CT could obtain more clearly enhanced images and show better characteristics of the tumor,had improved the diagnostic accuracy and staging ability for RCC. 2. The evidences of CT diagnostic RCC:①RCC morphology is like-round,round,and irregular tumor. ②Plain scanning values are among 30-50HU ( >20HU ) ,while enhancement values are above 30HU which are bellow renal parenchyma, small(≤3cm-diameter)tumor usually have a homogeneous appearance, while larger lesions tend to be more heterogeneous owing to hemorrhage, necrosis,cystiform. ③Calcifications in tumor or surrond the margin of that are possible malignant indications.④The short-hair sign surround the margin of tumor which links Gerota fascia is another important malignant sign.⑤Metastases findings: tumor in Gerota fascia tumoral thrombusin vessels enlargement of lymph nodes, local extention and distant metastases. 3. CT plays a important role in preoperative staging and differential diagnosis of RCC. 4. The characteristics of RCC CT imaging were related to their cellular type and structures in pathology. The sign of short-hair surround the margin of tumors strongly implied renal envelope involvement. No certain relations had been found between cellular types and CT types of RCC. The research had found that there were relations between morphological exhibition of tumor margin and status of tumor envelope.
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