目的 探讨螺旋CT多期增强扫描 对肾癌的临床诊断价值。方法 回顾性分 析本院2009年4月-2015年8月经病理证实 115例肾癌患者的CT影像资料，观察CT图 像表现，并以手术病理结果为对照，评价 螺旋CT多期增强扫描对肾癌分期、分型的 诊断价值。结果 CT诊断肾癌I期50例，II 期35例，III期20例，IV期10例，与手术 病理结果对照，诊断总符合率80.0%。不 同亚型肾癌患者CT平扫期、动脉期、实 质期、排泄期CT值比较差异有统计学意 义(P＜0.05)。透明细胞癌动脉期、实质 期、排泄期CT值分别显著高于嫌色细胞 癌、乳头状癌(P＜0.05)。乳头状癌平扫 期CT值为(42.9±8.6)HU，显著高于透明 细胞癌、嫌色细胞癌的(36.6±6.0)HU、 (35.7±5.3)HU，差异有统计学意义(P ＜0.05)。CT显示类圆形病灶84个；强化 模式：透明细胞癌以不均匀强化为主，嫌 色细胞癌以均匀强化为主。结论 螺旋CT 多期增强扫描因其密度、强化等特点对肾 癌分期诊断准确率较高，有助于肾癌临床 分型。

Objective To investigate the value of spiral CT multi-phase enhanced scan in the diagnosis of renal cancer. Methods The CT imaging data of 115 patients with renal cancer confirmed by pathology in our hospital between April 2013 and August 2015 were analyzed retrospectively. The CT findings were observed. With surgical and pathological results as control, the diagnostic value of spiral CT multi-phase enhanced scan in staging and typing of renal cancer was evaluated. Results CT diagnosis showed that there were 50 cases in stage I of renal cancer, 35 cases in stage II, 20 cases in stage III and 10 cases in stage IV. Compared with surgical and pathological results, the total coincidence rate was 80.0%. There were significant differences in CT values of plain scan phase, arterial phase, parenchymal phase and excretion phase between patients with different subtypes of renal cancer (P<0.05). The CT values of clear cell carcinoma in arterial phase, parenchymal phase and excretion phase were significantly higher than those of chromophobe cell carcinoma and papillary carcinoma (P<0.05). The CT value of papillary carcinoma in plain scan phase (42.9±8.6) HU was significantly higher than that of clear cell carcinoma and chromophobe cell carcinoma [(36.6±6.0) HU, (35.7±5.3) HU] (P<0.05). CT showed that there were 84 round lesions; In terms of enhancement pattern, clear cell carcinoma was with inhomogenous enhancement and chromophobe cell carcinoma with homogeneous enhancement. Conclusion Because of features such as density and enhancement, the accuracy rate of spiral CT multi-phase enhanced scan in diagnosis of clinical stage of renal cancer is high, which is helpful to the diagnosis of renal cancer.