| Many of the renal tumor incidence rate of high grade, poor prognosis, its early and accurate diagnosis and differential diagnosis is particularly important is the selection of appropriate treatment programs and improve patient survival, an important basis for judging the prognosis. Prior to the application of multi-slice spiral CT, conventional imaging technology can be found although the tumor, but only show the tumor's shape, and the requirements of tumor is large enough, clear the border, for a diameter less than 500um small lesions are still powerless. With imaging technology in recent years, the constant development of multi-slice spiral CT (MSCT) upgrade, and a series of electron-beam CT image-processing software successfully developed, the technology used in CT perfusion imaging of renal tumors in clinical practice. Kidney Cancer Diagnosis from the original only in the imaging study to show the form of tissues and organs anatomical structures, tissues and organs and bounds to reflect the hemodynamic information from the molecular level to the kidneys to carry out quantitative analysis, the diagnosis of kidney tumor morphology near Yongyue functional imaging study with the effective integration of a new era, and CT perfusion imaging technology, scanning time is short, simple operation, non-invasive, high spatial resolution, calculation of convenience, without radioisotopes, clinical popularity of Canton, the price of economic easy patient may be intuitive tissues and organs reflect the hemodynamic status, etc., making it the imaging study of this century one of the hotspots, and their kidneys may be in the body organs with visual comparison, for the clinical problems, occult lesions may be early detection, etc. allows the rapid development of CT perfusion imaging and applied to kidney research. In this study, the use of CT perfusion to the kidneys of benign and malignant diagnosis and differential diagnosis of the study, the analytical results and pathology results were compared to explore the technology, CT perfusion imaging in clinical application.The purpose of this study were collected in our hospital for CT perfusion examination six cases of normal volunteers, 18 cases of renal cell carcinoma were 20 lesions, renal angiomyolipoma with 15 cases of a total of 17 lesions, lesion size of approximately 245-22870m㎡. 6 cases of normal control group (no fever, lower back pain, high blood pressure, no history of abdominal diseases, urinary tract-related check indicators are normal), 4 cases of male, female 2 cases, age 25-55 years old, average age about 35 years of age; renal cell carcinoma 18 cases of a total of 20 lesions (clinical to hematuria, fever, pain, high blood pressure treatment), male 11 cases, seven cases of women, aged 35-60 years old, average age about 45 years of age; of renal angiomyolipoma with 15 cases of a total of 17 lesions (Clinical to hematuria, low back pain treatment), 6 males and 9 females, age 40-65 years old, average age about 50 years. The use of American GE company LightSpeed CT 16 splice or 64 splice multi-slice spiral CT scanners, everything is ready, the first scan Ridney selection process, first kidney conventional non-enhanced scan and found that after lesions to renal door level or the largest dimension of tumor as the center select perfusion scan level (the level as far as possible, including the abdominal aorta, renal and renal artery and vein) is the target plane. American GE company LightSpeed CT16 splice or 64 splice multi-slice spiral CT scanners, scanning the range of 2cm-4cm, select the layer 8 consecutive repeated 800 tomography. Scanning conditions: multi-scan mode with the layer Movies, thickness for 5mm/4i or 8i, layer spacing of 5mm away from the array for 512 * 512, 0.5s / loop, voltage 120Kv, tube current of 100mA. Scan interval time for 2-5s. ROIs (ROA) in the size range between 30-40 m㎡. Measurement of renal cortex were selected and renal medullary perfusion and lesion area parameter values. Perfusion imaging by using high-pressure syringe into the elbow vein Express Ultravist (Utravist, 370mgl/ml; Guangzhou Pharmaceutical Company Schering) 50ml, injection speed of 4.5-5.0ml / s. Scan after the completion of the acquisition of the data transmission to AW4.2 or 4.3 workstations, application software for CT perfusion 3 renal perfusion analysis. CT Perfusion 3 to enter the body perfusion software package Ridney treatment of analytical data. First, select the level to enter the images to determine the CT value range, manually adjust the purpose of reducing air and the formation of bone tissue space noise, so as not to affect the authenticity of data. And at the same level of abdominal aorta (renal artery showed smaller poor, the selection in place of abdominal aortic renal artery) in select regions of interest (region of interest, ROI), the size requirements of the control in the 2-6Pix, the purpose of avoiding volume effect impact. After the automatic processing by computer generated time - density curves (time-density curve, TDC), according to TDC select the scope of the deal with images, the computer automatically generated again with a color-coded perfusion parameter maps, and the corresponding perfusion parameters, namely blood flow (blood flow, BF), Blood volume (blood volume, BV), mean transit time (mean transit time, MTT), permeability surface (permeability surface, PS). With the above-mentioned procedure is the same principle of selection with renal tumor and normal kidney tissue of interest areas, corresponding perfusion parameters of BF, BV, MTT, PS perfusion value, based on the above numerical analysis and evaluation of kidney tissue perfusion status. The results show that 1. The results of this study show that renal tumor perfusion scan obtained by the various parameters and tumor microvessel density has significant relevance. Able to more accurately reflect the abundance of tumor blood vessels can be used as the preoperative diagnosis and evaluation of prognosis in essential reference. 2. Renal BF, BV was significantly higher than the normal control group, renal tissue and the contralateral renal tissue without lesions (p <0.05). MTT was significantly shorter, (p <0.05). The higher the grade of renal cell carcinoma, MTT shortened the more obvious may be small lesions and early detection of metastases, has significant clinical value of 3. Angiomyolipoma of BF, BV renal tissues of normal control group and the contralateral No lesions in renal tissue, cortex BV higher than the normal control group and contralateral kidney tissue without lesions in renal tissue, renal angiomyolipoma with non-vascular area BF, BV and there are some differences in renal cell carcinoma. MTT shorter than normal renal tissue, but shorter than in renal cell carcinoma of renal angiomyolipoma (p <0.05). Can help them carry out pre-operative diagnosis, the size of the scope of a clear focus, a significant differential value of benign and malignant kidney. 4. Renal perfusion studies due to the symmetry of the kidneys for organ retroperitoneal easy comparison with the same body and blood for the rich, by the respiratory effects of small, suitable perfusion parameters become a prerequisite of Health; through existing CT equipment without the use of radioisotopes, excellent price-lim , image resolution, easy to operate, convenient calculation of advantages, for a comprehensive analysis of perfusion parameters, the correct diagnosis of benign and malignant kidney tumor, early detection of occult and minimal disease, for clinicians to choose the correct treatment program, and a good prognosis Helped to provide a favorable effect has important clinical significance. 5 perfusion technology and development, marking the images from the traditional study of anatomy to morphology, while reflecting the general macro-morphology, but also reveals the micro-metabolism and function of direction. Have broad clinical applications.Blood volume (blood volume, BV), mean transit time (mean transit time, MTT), permeability surface (permeability surface, PS). With the above-mentioned procedure is the same principle of selection with renal tumor and normal kidney tissue of interest areas, corresponding perfusion parameters of BF, BV, MTT, PS perfusion value, based on the above numerical analysis and evaluation of kidney tissue perfusion status. The results show that 1. The results of this study show that renal tumor perfusion scan obtained by the various parameters and tumor microvessel density has significant relevance. Able to more accurately reflect the abundance of tumor blood vessels can be used as the preoperative diagnosis and evaluation of prognosis in essential reference. 2. Renal BF, BV was significantly higher than the normal control group, renal tissue and the contralateral renal tissue without lesions (p <0.05). MTT was significantly shorter, (p <0.05). The higher the grade of renal cell carcinoma, MTT shortened the more obvious may be small lesions and early detection of metastases, has significant clinical value of 3. Angiomyolipoma of BF, BV renal tissues of normal control group and the contralateral No lesions in renal tissue, cortex BV higher than the normal control group and contralateral kidney tissue without lesions in renal tissue, renal angiomyolipoma with non-vascular area BF, BV and there are some differences in renal cell carcinoma. MTT shorter than normal renal tissue, but shorter than in renal cell carcinoma of renal angiomyolipoma (p <0.05). Can help them carry out pre-operative diagnosis, the size of the scope of a clear focus, a significant differential value of benign and malignant kidney. 4. Renal perfusion studies due to the symmetry of the kidneys for organ retroperitoneal easy comparison with the same body and blood for the rich, by the respiratory effects of small, suitable perfusion parameters become a prerequisite of Health; through existing CT equipment without the use of radioisotopes, excellent price-lim , image resolution, easy to operate, convenient calculation of advantages, for a comprehensive analysis of perfusion parameters, the correct diagnosis of benign and malignant kidney tumor, early detection of occult and minimal disease, for clinicians to choose the correct treatment program, and a good prognosis Helped to provide a favorable effect has important clinical significance. 5 perfusion technology and development, marking the images from the traditional study of anatomy to morphology, while reflecting the general macro-morphology, but also reveals the micro-metabolism and function of direction. Have broad clinical applications.In short, multi-slice spiral CT perfusion imaging can be a very good show renal cell carcinoma, renal angiomyolipoma blood perfusion characteristics, providing information on their hemodynamic information, at the molecular level to the kidneys to carry out quantitative analysis. As a functional imaging has become benign and malignant renal diagnosis and differential diagnosis, improve treatment and prognosis of the effect of an important means to have broad clinical applications.
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