| Objective Through analyzing multi-slice spiral CT imaging performance, combining with the pathogical manifestation and interal structure in small renal cell carcinoma, to evaluate the role of multi-slice spiral CT imaging performance in the detection of small renal cell carcinoma and improve its diagnosis and differential diagnosis.Material and Method1.we analyze retrospectively 408 cases renal cell carcinoma which inspected in the department of urology surgery of Affiliated Hospital of Qingdao University Medical College in January 2006 to December 2009 period. They all had been carried out with renal CT and confirmed by pathology.We chose 42 cases small renal cell carcinoma from 408 cases,33 males and 9 females, Age ranges from 23 to 76 years,with an average 55.4 years.there were 2 cases of painless hematuria.2 cases had lower back pain.The other 38 cases had no urinary tract symptoms,which were discovered accidentally by physical examination or other diseases examination. To observe the density of CT scan, enhanced degree,tumor cell type,cell arrangement,internal structure and so on.Comprised' between CT and pathologic manifestations,To study CT enhanced degree in histological types.2.1nspection Methods Using multi-phase scanning with Siemens SOMATOM 64-slice CT system Methods:CT scan1)Before the exmination Patients fasted 8 hours routinely,next patients took 3% Meglucamine diatrizoate 800-1000ml to fill gastrointestinal tract.2) We first made both kidneys CT noncontrast enhanced scan,and then made CT multi-stage contrast enhanced scan. A loversol-Contrast Agent is used with 300mgl/ml, Total injection with 100ml, Injection rate by 4ml/s.Scanning parameters:Tube voltage 120-140KV, Effective tube current 300mAs,Collimation 5mm,scanning speed 0.5s/360°.3) Injecting the contrast agent,20-25s later we made the cortical phase enhanced scanning, 60-90s later we made the real phase scanning at the same conditions,3-5min later we made the renal pelvis phase scanning. Patients should be in a state of breath-hold during the scan3.The CT images were analysed and diagnosed by two senior radiologists in blind way.Results In this study, patients with small renal cell carcinoma diagnosed by CT imaging findings in 42 cases and all confirmed by surgery and pathology. In the correct diagnosis of 42 cases of small cell carcinoma pathology report,see the most clear cell carcinoma,a total of 33 cases,accounting for seventy eight point six.papillary renal cell carcinoma four cases,chromophobe renal cell carcinoma three cases,multilocular cystic renal cell carcinoma two cases,all were unilateral. Among the 42 cases Clear cell carcinoma,27 cases are for real cells,which can be seen a wealth of sinus-like blood vessels,but the degree is different. Small renal cell carcinoma plain for low-density, density, high density, density and low-density more.Most of enhanced scan showed typical "fast into fast forward "feature, that is, the cortex strengthen significantly, the declining in real terms.Multi-slice spiral CT of the kidney-shaped change, pseudo capsule, cystic change, hemorrhage diagnostic accuracy rate was 95.2%,42.9%,85.7%,92.9%.Lymph node metastasis and other ogan metastasis are not exist according to CT image and operation. There are not the invasion of adjacent organ.Conclusion1.Multi-slice spiral CT has increased both the scaning speed and lower noise, and reduce the volume effect. Multi-phase imaging of multi-slice spiral CT for small renal cell carcinoma is importantant value to diagnosis and differential diagnosis.2.CT manifestations of small renal cell carcinoma is relation with pathological type and the tumor internal structure.3.Multi-slice spiral CT can improve the detection and diagnosis of small renal cell carcinoma correctness,which should be used as small renal cell carcinoma to be one of the ways. |
PDF Full Text Request