螺旋CT及MRI在鉴别肾脏囊性占位病变中的作用

目的分析肾脏囊性占位病变的CT与MRI表现,并评价其对鉴别良恶性病变的临床意义。方法 151例由手术病理证实的肾脏囊性占位病变患者,包括多发囊肿125例,海绵状血管瘤16例及囊性肾癌10例,均经CT与MRI平扫及增强扫描。比较了CT与MRI对肾脏囊性占位病变的诊断能力。结果 151例中,CT诊断肾囊肿118例,血管瘤16例,以及囊性肾癌17例,其诊断敏感性,特异性及准确性分别为58.8%,95.0%及95.4%;MRI诊断肾囊肿122例,血管瘤16例,以及囊性肾癌13例,其诊断敏感性,特异性及准确性分别为76.9%,98.8%及98.0%。CT对肾良性病变低估7例,对恶性病变高估了7例,而MRI对肾良性病变低估3例,对恶性病变高估3例。结论 CT与MRI二者都能对血管瘤作出正确诊断,而在肾囊肿与囊性肾癌的诊断及鉴别诊断中,MRI明显优于CT。

Application of CT and MRI for differentiating benign from malignant cystic renal space-occupying lesions

Objective To analyze the CT and MRI findings of cystic renal space-occupying lesions（CRSOLs） and to assess their clinical significance for differentiating benign from malignant CRSOLs.Methods A hundred and fifty-one patients with surgically and pathologically proved CRSOLs which comprised 125 multiple renal cysts,16 cavernous angiomas,and 10 cystic renal carcinomas underwent CT and MRI scans without and with contrast-enhanced.The capability of CT for differentiating benign from malignant CRSOLs was compared with that of MRI.Results Among 151 cases,CT diagnosed 118 renal cysts,16 angiomas,and 17 cystic renal carcinomas,in whom,the diagnostic sensitivity,specificity and accuracy of CT were 58.8%,95.0% and 95.4%,respectively;MRI diagnosed 122 renal cysts,16 angiomas and 13 cystic renal carcinomas,its diagnostic sensitivity,specificity and accurancy were 76.9%,98.8% and 98.0%,respectively.CT underestimated 7 cases of benign lesions and overestimated 7 cases of malignant lesions,while MRI underestimated 3 cases of benign lesions and overestimated 3 cases of malignant lesions.Conclusion The both of CT and MRI can definitely diagnose the angioma but MRI in the diagnosis and differential diagnosis of CRSOLs is significantly superior to CT.