Dai J R, Shi M L
Cancer Hospital, Chinese Academy of Medical Sciences, Beijing.
Zhonghua Zhong Liu Za Zhi. 1991 Jan;13(1):49-51.
Seven cases (8 tumors) of small renal carcinoma (less than 3 cm in diameter) proven by pathology were reviewed. It accounted for 7% of patients with renal cell carcinoma during the same period. Sonogram was hypoechogenic in 3 tumors, isoechogenic in 2 and slightly hyperechogenic in 3. Heteroechogenicity was shown in 3 cases and homoechogenicity in 5. None of the margins was sharp. CT scan showed 4 isodense, 1 hypodense and 1 slightly hyperdense masses. After contrast enhancement, increased attenuation to different degrees but still lower than the normal renal parenchyma was observed. The sensitivity of IVP was low because of the small size of the tumor, peripheral location and rare involvement of the renal calyces and pelvis. MRI is helpful in differential diagnosis of hilar adenopathy and small vessels for tumor staging. Yet, the value of MRI for renal masses should be further studied. On cost benefit, sonography and CT are more practical in the diagnosis of renal carcinoma.
回顾了7例(8个肿瘤)经病理证实的小肾癌(直径小于3cm)。其占同期肾细胞癌患者的7%。超声检查显示3个肿瘤为低回声,2个为等回声,3个为轻度高回声。3例表现为不均匀回声,5例为均匀回声。所有肿瘤边界均不清晰。CT扫描显示4个等密度、1个低密度和1个轻度高密度肿块。增强扫描后,肿块呈不同程度强化,但仍低于正常肾实质。由于肿瘤体积小、位于周边且很少累及肾盏和肾盂,静脉肾盂造影(IVP)的敏感性较低。磁共振成像(MRI)有助于鉴别肾门淋巴结肿大和小血管以进行肿瘤分期。然而,MRI对肾肿块的价值仍需进一步研究。从性价比来看,超声和CT在肾癌诊断中更实用。