目的 探讨螺旋CT增强扫描对肾 癌患者的临床鉴别诊断价值。方法 回顾 性分析我院在2013年12月-2015年12月期 间接收并经手术病理证实的84例肾癌疾 病患者的临床及螺旋CT检查资料，观察 其影像学特征，并与病理诊断结果进行 对照分析。结果 本组84例肾癌患者经螺 旋CT平扫，肿瘤位于肾上极38例、位于 肾下极34例、位于肾窦附近处7例、占 据全肾5例；肿瘤的直径在1.2cm-13cm 之间，平均直径为(8.2±2.4)cm；肿瘤 的形态主要为圆形或类圆形、不规则 形；CT分型与手术病理分型的符合率为 83.3%；CT平扫表现为肾实质占位病变， 瘤体与肾实质分界不清，CT增强扫描瘤 体各时期强化程度不同，均低于正常肾 实质。结论 螺旋CT尤其是增强扫描能够 清楚地显示出肾癌患者肿瘤的位置、大 小、形态、范围，并能够准确测定肿瘤 的密度和进行分型，在肾癌的临床鉴别 诊断中具有较高的应用价值，值得进一 步推广应用。

Objective To investigate the value of spiral CT enhanced scanning in the differential diagnosis of renal cell carcinoma. Methods Retrospective analysis of the clinical and spiral CT data of 84 patients with kidney disease confirmed by surgery and pathology in our hospital from December 2013 to December 2015. And observed the imaging features and compared with pathological diagnosis results. Results In this group of 84 cases of renal cell carcinoma patients with spiral CT scan, the tumor is located in the upper pole of the kidney in 38 cases, located in the lower pole of the kidney in 34 cases, located near the renal sinus in 7 cases, occupy the whole kidney in 5 cases. The diameter of tumor was 1.2cm~13cm, and the mean diameter was (8.2±2.4)cm. The shape of the tumor was round or oval shaped, irregular shape. The coincidence rate of CT typing and surgical pathologic typing was 83.3%. CT plain scan showed renal parenchymal lesions, the tumor volume was not clear, and the enhancement degree of CT was lower than that in normal renal parenchyma. Conclusion Spiral CT, especially enhanced scan can clearly show the location, size, shape and range of the tumor, and can accurately measure the density of the tumor. It has high application value in the clinical differential diagnosis of renal cell carcinoma. It is worthy of further promotion and application.