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目的探讨肾细胞癌(RCC)侵犯肾包膜的多层螺旋CT征象。方法 158例经病理证实的RCC患者158例,分为侵犯组(45例)与未侵犯组(113例),分析其多层螺旋CT表现,包括病灶的位置类型、边缘类型、肾周脂肪间隙。结果RCC的位置类型在两组间的分布无统计学差异(P>0.05)。两组光滑、深分叶和锯齿征分布有统计学差异(P<0.01),而浅分叶分布无统计学差异(P>0.05)。侵犯组肾周脂肪间隙强化结节多于未侵犯组(P<0.01)。侵犯组的肾周脂肪密度为-(91.12±14.41)HU,未侵犯组的肾周脂肪密度为-(96.43±8.38)HU,两组差异无统计学意义(P>0.05)。结论多层螺旋CT征象是诊断RCC侵犯肾包膜的重要手段,边缘类型和肾周脂肪间隙强化结节是判断RCC侵犯肾包膜的重要征象。
Objective To investigate the multi-slice CT signs of renal cell carcinoma (RCC) invading the renal capsule. Methods A total of 158 patients with pathologically confirmed RCC were divided into two groups: infiltrative group (n = 45) and noninvasive group (n = 113), and their multi-slice spiral CT findings were analyzed including location type, marginal type, perirenal fat gap . Results There was no significant difference in the location type of RCC between the two groups (P> 0.05). There were significant differences between the two groups in the distribution of smooth, deep lobes and serrations (P <0.01), while the distribution of shallow lobes was not statistically different (P> 0.05). Periurethral fat gap enhanced nodules more than the non-infiltration group (P <0.01). Peri-renal adipose tissue density was - (91.12 ± 14.41) HU in non-inflicted group, and - (96.43 ± 8.38) HU in noninvasive group. There was no significant difference between the two groups (P> 0.05). Conclusion MSCT is an important method to diagnose RCC invasion of the renal capsule. The marginal type and perirenal fat gap enhanced nodules are important signs of RCC invasion of the renal capsule.