目的 探讨多层螺旋CT多期增强 扫描诊断肾癌的应用价值。方法 回顾 性分析2013年4月-2015年5月我院48例 经手术病理证实为肾癌的CT平扫及多期 增强扫描的影像资料，并与临床病理对 照。结果 CT诊断肾癌分期总准确率为 89.58%(43/48)；动脉期扫描CT值明显高 于平扫及实质期，平扫、实质期扫描组 间比较差异有统计学意义(P＜0.05)。CT 扫描显示43例病灶突出肾轮廓外，5例局 限于肾轮廓内。平扫密度较为复杂，2例 出血表现为高密度影，5例伴随囊变、出 血，4例钙化。动脉期均有不同程度中度 强化和明显强化，40例动脉期增强后可 见清晰边界，28例可见假包膜，17例可 见“短刺”征；肾实质期扫描，强化程 度明显减弱，静脉期强化程度进步一减 弱。结论 多层螺旋CT多期增强扫描在诊 断肾癌及分期中具有较高的应用价值。

Objective To explore application value of multisliecs helieal CT multi phase enhanced scan in the diagnosis of renal cell carcinoma. Methods A retrospective analysis of imaging data of CT scan and multiphase enhanced scan was carried out in 48 patients with renal cell carcinoma confirmed by operation and pathology in our hospital from April 2013 to May 2015, the results were compared with clinical and pathological data. Results Total accuracy rate of CT in the diagnosis of renal cell carcinoma staging was 89.58% (43/48). CT arterial phase scanning CT value was significantly higher than plain scan, parenchymal phase scanning, there was a significant difference in plain scan, parenchymal phase scanning in these groups (P<0.05). CT scan showed that 43 cases had prominent renal contour lesions, and lesions in 5 cases were confined to the renal contour. Plain scan density was more complex, 2 cases of hemorrhage showed high density shadow, 5 cases were complicated with cystic change, hemorrhage, 4 cases of calcification. There were moderate enhancement and obvious enhancement in different degrees in arterial phase, clear boundary could be seen in 40 cases after enhancement in arterial phase, pseudocapsule could be seen in 28 cases, close needling sign in 17 cases, enhancement degree was significantly reduced in kidney parenchymal phase scan, enhancement degree in venous phase was further reduced. Conclusion Multisliecs helieal CT multiphase enhanced scan has higher application value in the diagnosis and stage of renal cell carcinoma.