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[复杂性肾囊肿的评估:CT与磁共振成像的比较]

[Evaluation of complicated renal cyst: a comparison of CT and MR imaging].

作者信息

Yamazaki Y, Toma H, Nakazawa H, Nakamura R, Kato N, Ryoji O

机构信息

Department of Urology, Tokyo Women's Medical College.

出版信息

Hinyokika Kiyo. 1992 Jun;38(6):635-40.

PMID:1632316
Abstract

We report 12 cases of renal cystic lesions that could not be diagnosed preoperatively. Sonography, computed tomography (CT), magnetic resonance (MR) imaging, and angiography were performed in all cases. Angiography was not helpful in evaluating cystic lesions, because all cystic lesions were hypovascular or avascular within the cystic mass. CT was useful in depicting the fine structural abnormalities, and especially bolus-contrast CT study was useful in the differentiation of cystic renal cell carcinoma from simple renal cyst. However, there were 5 false positive cases. MR imaging is superior to CT in distinguishing a hemorrhagic cyst or multiloculated cystic mass. In conclusion, CT is currently the primary imaging modality for evaluating complicated renal cysts, and surgical exploration is warranted for the undiagnosed cystic lesion by CT. However, MR imaging also has an important role in detecting the benign complicated cyst. Therefore if complicated cyst is thought to be benign by MR imaging, parenchyma-sparing surgery should be considered preoperatively.

摘要

我们报告了12例术前无法确诊的肾囊性病变。所有病例均进行了超声检查、计算机断层扫描(CT)、磁共振(MR)成像和血管造影。血管造影对评估囊性病变并无帮助,因为所有囊性病变在肿块内均为低血供或无血供。CT有助于显示细微的结构异常,尤其是团注对比剂CT检查对肾囊性癌与单纯肾囊肿的鉴别诊断很有用。然而,有5例假阳性病例。MR成像在鉴别出血性囊肿或多房性囊性肿块方面优于CT。总之,CT目前是评估复杂性肾囊肿的主要影像学检查方法,对于CT无法确诊的囊性病变有必要进行手术探查。然而,MR成像在检测良性复杂性囊肿方面也具有重要作用。因此,如果MR成像认为复杂性囊肿为良性,则术前应考虑保留肾实质手术。

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