【摘要】 目的　应用动态CT(DCT)扫描技术 ,评价其对肾脏占位病变的诊断价值并探讨肾肿瘤的DCT特征与病理表现的关系。材料与方法　对 3 3例B超或体检中怀疑为肾脏占位的患者 (计 3 5个病灶 )运用DCT扫描技术进行前瞻性研究 ,将其结果与手术病理、脱落细胞学、影像综合诊断、临床随访结果对照比较。结果　 ( 1)手术病理证实 17例 ,穿刺活检及脱落细胞学检查证实 2例 ,超声、血管造影、MRI等综合诊断及临床随访 14例。( 2 )DCT对肾脏占位病变良、恶性鉴别诊断的敏感性为 92 .86% ,特异性为 95 .2 4% ,准确性为 94.2 9% ,阳性预测值为 92 .86% ,阴性预测值为 95 .2 4% ,约登指数为 0 .881,与病理对照Kappa值为 0 .88。 ( 3 )不同的肾脏肿瘤DCT的表现特征如CT值、强化模式、钙化、肿瘤血管等各不相同。结论　DCT扫描对肾脏肿块诊断准确性高 ,对肿块的良、恶性鉴别有一定的价值 ,但对表现特殊的肾脏肿块的定性诊断、良性肿瘤合并出血及恶性肿瘤Ⅰ、Ⅱ期的诊断还存在一定的困难。更多还原

【Abstract】 Objective To evaluate dynamic CT (DCT) in the diagnosis of renal space occupying lesions and to study the correlation between the imaging features of renal tumors and their pathologic findings.Materials and Methods DCT was performed in 33 patients with suspected renal space occupying lesions, the results were compared with the surgical, pathological, cytological and clinical findings.Results (1) Diagnosis was pathologically proved in 19 patients. Additional ultrasound, MRI or DSA were carried out in 14 patients. (2) The sensitivity of differentiating benign with malignant was 92.86%, while the specificity was 95.24%, accuracy 94.29%. PPV and NPV were 92.86% and 95.24%, respectively. Yourden index was 0.881. Kappa number was 0.88. (3) The expression of imaging features of renal tumors, such as CT value, enhancement pattern, calcification, tumor vessels, was different from patient to patient. Conclusion DCT is very useful in detecting and diagnosing renal masses, and also in distinguishing benign and malignant lesions.更多还原