Evaluation Of Multi-phase MSCT Scanning In The Diagnosis And Staging Of Renal Cell Carcinoma

Renal cell carcinoma call for short renal carcinoma. Renal carcinoma is one of the most common malignant tumor of the renal parenchyma. The morbidity of kidney carcinoma is the second place of urination department. RCC was dominant to be found in the man with age over 40 years old. The radio between male and female is 2:1. Most of the tumors were clear cell carcinoma in pathology (70%). The clinical symptom of renal carcinoma in its early stage is usually obscured. Hematuria and lumbago and abdominal mass are the trilogy sign of kidney carcinoma, the clinic occurrence is short 15%, and these patients often are advanced stage. In the twenty years recently, US,CT and MRI are made generally. More and more renal carcinoma is found in early stage by accident. Foreign scholar report it is over 50%. Multi-phase spiral CT scanning is not much cheaper, but being used generally.Recently years CT technology developed very quickly, CT has developed from general CT to spiral CT. The spiral CT has developed to double row and to 64 rows. It scanning speed is moreand more fast, thickness is more and more thin, aftertreatment function is more and more mightiness. Multi-phase spiral MSCT scanning has not only capability of showing the density, but also capability of showing the blood supply of the tumor. It is accurate to diagnose staging of the tumor, and may contribute greatly to the choice of the treatment.The MSCT findings of 65 cases of renal cell carcinoma proved by surgery and pathology were analyzed retrospectively. Among which 46 were males and 19 females, ranging from 18 to 82 years old, with an average of 56.1 years old. We collected all cases scanned by GE Lightspeed 16 row CT scanner. A total amount of 100ml Omnipaque or Ultravist was administered with a powerful injector at a flow rate of 3.0ml/sec. The CT parameters are 120KV and 380～400mA, layer thickness is 5.0mm, interlayer spacing is 5.0mm, all the data were reconstructed by thin thickness and observed with three dimension-reconstruction software, we can diagnosis all of the cases accurately by 16 row CT. The morphologic features including tumor size, contrast enhanced pattern, incasion of perinephric fat, renal vein and inferior vena cava as well aslymphadenopathy were evaluated.The statistical analysis is perform with a PASS 10.0 software. RCC appear as different size and heterogeneous density, to kidney convex dished out. It may has hemorrhage, vesicae change, colliquation, necrosis and calcify within the tumor. Accordind to the statistical analysis, the computerized tomographynumber in every phase of patients without correlated symptoms comparing with it of patients with correlated symptoms have no statistical significance(P>0.05). The comparison of computerized tomographynumber in different scanning phase have statistical significance ( P<0.05 ) .he computerized tomographynumber in cortical phase of clear-cell carcinoma comparing with it of other pathological types have statistical significance ( P<0.05 ) .The same to the computerized tomographynumber in parenchymal phase of the two types tumors mentioned above. The pathological results showed that 46 cases were clear cell carcinoma, 8 cases were granular cell carcinoma, 3 cases were papillary renal cell carcinoma , 8 cases had combined the above two varieties, The results showed that preoperative MSCT in 72.72% of stageⅠ,75% of stageⅡ,89.23% of stageⅢand 100% ofstageⅣtumors were corresponded that of pathologic staging postoperatively. Overall, the rate of correspondence was 89.23%.Multi-phase scanning of MSCT may search not only tumor size, contrast enhanced pattern, incasion of perinephric fat, renal vein, inferior vena cava and lymphadenopathy, but also staging of the tumor. Intensify form may relate to pathology of renal carcinema. The stage of the patients without symptoms were lower than the stage of the patients with symptoms. In a word, Multi-phase scanning of MSCT and reconstruct are important supervise sense in diagnose and cTNM of renal carcinema.