目的通过肾脏MDCT多期增强扫 描，评价不同碘浓度对比剂对肾透明细胞 癌(clear cell renal cell carcinoma， ccRCC)强化的影响。资料与方法 回顾分 析经手术病理证实的49例ccRCC MDCT增强 扫描资料。根据对比剂碘浓度的不同分为 低碘浓度对比剂组(A组，300 mgI/ml)和 高碘浓度对比剂组(B组，370 mgI/ml)， 测量平扫、皮髓质期(corticomedullary phase，CMP)、实质期(nephrographic phase，NP)ccRCC及邻近正常肾皮质的CT 值。统计分析两组ccRCC的强化程度及 ccRCC与邻近正常肾皮质CT值差值(取CT 值差值的绝对值)。结果 B组ccRCC在皮 髓质期和实质期强化程度高于A组。皮 髓质期强化程度差异具有统计学意义(P ＜0.05)，实质期强化程度差异没有统计 学意义(P＞0.05)。B组ccRCC与邻近正常 肾皮质CT值差值在皮髓质期及实质期均 高于A组。皮髓质期差异没有统计学意义 (P＞0.05)，实质期差异具有统计学意义 (P＜0.05)。结论 肾脏MDCT多期增强扫描 中，对比剂注射速率相同时，ccRCC在高 碘浓度时皮髓质期强化程度较高，实质期 肾脏-肿瘤对比增加，因此高碘浓度对比 剂对ccRCC的显示效果优于低碘浓度对比 剂。

Objective The purpose of this study was to determine the influence of different concentration iodine contrast media on enhancement of clear cell renal cell carcinoma (ccRCC) in multiphasic contrast-enhanced MDCT of the kidney. Materials and methods We retrospectively reviewed the contrast-enhanced CT findings in 49 patients with ccRCCs proven postoperative pathology record, examinations were performed in multiple phases of enhancement with a MDCT scanner. According to the concentration of iodine contrast media, 49 patients were randomized into two groups. Group A received 100 mL of 300 mgI/mL and group B 75 mL of 370 mgI/mL. Attenuation values were measured at ccRCCs and the normal renal cortex in each phase (unenhanced, corticomedullary, and nephrographic). Statistical analysis was performed for comparison of the degree of enhancement of ccRCCs and the attenuation differences beween tumor and renal cortex. Results In the corticomedullary phase, the 370 mgI/mL concentration showed significantly higher tumor enhancement than 300 mgI/mL in (p<0.05), and there was however no significant difference in the attenuation differences beween tumor and renal cortex (p＞0.05). In the nephrographic phase there was no significant difference in tumor enhancement between the 370 mgI/mL and 370 mgI/mL concentrations (p＞ 0.05), and there was a significant difference in the attenuation differences beween tumor and renal cortex (p<0.05). Conclusion Given equivalent injection rate, the higher iodine concentration leads to a higher corticomedullary phase contrast enhancement of ccRCC and a higher nephrographic phase attenuation differences beween tumor and adjacent renal cortex in MDCT of the the kidney, therefore facilitate visualization of ccRCC in the corticomedullary phase and nephrographic phase.