【摘要】 目的 分析并总结肾盂癌的CT表现以及诊断价值。方法 回顾性分析自2008年11月至2010年11月期间实施手术以及通过病理证实的肾盂癌患者46例的CT表现特点。结果 全部46例患者均进行CT平扫，查出病灶位于左肾者44例，位于右肾者2例。平扫显示肾盂、肾盏内可疑结节以及包块影，同肾实质呈相等或稍低的密度，伴有肾盂积水者22例。实施强化扫描者36例，增强早期肿瘤结节和包块强化不显著；在实质期表现为轻至中等密度的强化，并且在皮髓质交界相不清晰，同侧肾皮质强化比不上对侧；在延迟期肾盂或肾盏内部表现为不规则充盈缺损，内部被软组织密度所填充。CT诊断和病理诊断的一致率达到95.89%。患者中有6例疑诊肾癌侵及肾盂，2例患者疑诊为肾多发结石，2例疑诊为肾盂肾炎。结论 肾盂癌的CT表现具有其自身的特点，动态增强扫描能够体现肿瘤的强化特征，给临床诊断提供有价值的鉴别依据。

    【关键词】 肾肿瘤；肾盂；体层摄影术；诊断

    The diagnostic analysis of CT for renal pelvic cancer in 46 cases

    YANG Zhi-qiang. CT room, The First People’s Hospital of Shangqiu City, Shangqiu 476100, China

    【Abstract】 Objective To analyze and summarize the renal pelvis cancer, and diagnostic value of CT. Methods From November 2008 to November 2010, the CT characteristics of 46 cases renal pelvic cancer by implement surgical and pathology were analyzed. Results All 46 patients underwent CT scan, detected lesions in the left kidney in 44 cases, in the right kidney in 2 cases. Scan showed renal pelvis, calyces and suspicious nodules within the mass shadow, with the renal parenchyma was equal to or slightly lower density, associated with hydronephrosis in 22 cases. Implementation of the enhanced scan in 36 patients, early tumor nodules and mass increasewas not significantly enhanced. In the parenchymal phase showed mild to moderate-density enhancement, and in the corticomedullary junction phase was not clear, enhanced ipsilateral inferior renal cortex contralateral. In the delayed phase within the renal pelvis or calyces showed irregular filling defect, internally filled with soft tissue density. CT diagnosis and pathological diagnosis consistent rate was 95.89%. 6 patients with suspected renal cell carcinoma invading the renal pelvis, 2 patients suspected of multiple kidney stones, 2 cases of suspected pyelonephritis. Conclusion The CT expression of renal pelvis cancer has its own characteristics, dynamic contrast-enhanced scans can reflect the enhanced features of the tumor, to provide valuable clinical basis for identification. ......