The Diagnosis Value Of Msct In The Subtypes Of Renal Cell Carcinoma

Objective:To explore the diagnosis and differential diagnosis value of MSCT in the subtypes of renal cell carcinoma and preferentially choose meaningful CT signs to further define the differential diagnosis standard.Materials and Methods:The Clinical Parameters and CT datas of the136patients with kidney cancer were retrospectively reviewed. There were112cases with clear cell RCC,15cases with papillary RCC and9cases with chromophobe RCC. The age of patients, tumor size, the enhancement degree the enhancement rang, the enhancement pattern, hemorrhage, necrosis and calcification and the spread of the tumor were compared among the three subtypes and the statistic analysis were done.Results:Clear cell carcinoma showed inhomogenous density by plain scan and "quick in quick out" enhancement by contranst scan and intratumoral necrosis was relatively common. Papillary carcinoma showed homogeneous density by plain scan, partly with bleeding, calcification, and mild-to-moderate strengthening, with a delay strengthen trend by contranst scan; Chromophobe carcinoma showed homogeneous density by plain scan, partly with calcification and mild-to-moderate strengthening by contranst scan, with a delay enhancement in nephrographic period. There were no statistic differences on the age,the tumor size and plain ct value among the three subtypes of renal cell carcinoma (P>0.05). The density of tumor, calcification, hemorrhage and the manifestation of enhancement (the degree of enhancement、Strengthen range、the types of the enhancement) had statistic significant difference (P<0.05). The average CT value of clear cell carcinoma was significantly higher than that of papillary carcinoma and chromophobe carcinoma in corticomedullary, nephrographic and excretory phase by enhancement scan. The statistical differences of dynamic change on the enhancement range between clear cell carcinoma and papillary carcinoma, chromophobe carcinoma exsited. The enhancement manifestation of clear cell carcinoma was quick in quick out while the papillary carcinoma and chromophobe carcinoma showed gradually increasing enhancement. Clear cell carcinoma and papillary carcinoma were uneven enhancement while the chromophobe carcinoma was homogeneity strengthen, there were statistical differences. Compared to clear cell carcinoma, the density was more evenly than that in papillary carcinoma and chromophobe carcinoma by plain scan. The rate of bleeding in papillary carcinoma was higher than the one in clear cell carcinoma. The rate of Calcification in papillary carcinoma and chromophobe carcinoma was higher than the one in clear cell carcinoma.Conclusion:The MSCT manifestation of the subtypes of renal cell carcinoma have certain features and it is very important for the diagnosis and differential diagnosis. The strengthening of the tumor was important parameter for the differential diagonosis in the subtypes of renal cell carcinoma. The presence or absence of intratumoral hemorrhage, cystic degeneration necrosis and calcification and the patters of the enhancement are important to the diagnosis of the subtypes of renal cell carcinoma. According to the clinical examination and CT examination results, it could play an important clinical guidance function for diagnosising subtype of renal cell carcinoma, the judging of the disease outcomes and formulating theraputical plan preoperatively.