Miles K A, London N J, Messios N, Smart J G
Department of Radiology, Leicester Royal Infirmary.
Clin Radiol. 1990 Aug;42(2):122-7. doi: 10.1016/s0009-9260(05)82083-5.
Two dynamic computed tomographic methods used for staging renal carcinoma in 46 patients are described and compared. Twenty-eight patients were examined using an infusion technique during incremental dynamic scanning across the kidneys with contrast administered via an arm vein. Eighteen patients were staged using a technique comprising a single location dynamic scan sequence at the level of the renal hilum followed by an incremental sequence during an infusion of contrast into the femoral vein. When compared with overall pathological staging, the arm vein infusion technique correctly staged 20 patients (72%) with four patients (14%) understaged and four (14%) overstaged. The femoral vein infusion and single location dynamic scanning technique correctly staged 11 (61%) patients with three (17%) overstaged and four (22%) understaged. The femoral vein infusion with single location scanning was more accurate in demonstrating tumour involvement of the renal vein (83.3% correct vs. 78.6%), inferior vena cava (94.4% correct vs. 89.3%) and lymph nodes (88.9% correct vs. 78.6%) but was less accurate in assessing extracapsular spread (77.8% correct vs. 96.4%). The additional information obtained from the single location dynamic sequence is sufficiently valuable for this part of the second technique to be used in any scanning protocol for staging renal carcinoma.
本文描述并比较了用于46例肾癌分期的两种动态计算机断层扫描方法。28例患者采用经手臂静脉注射造影剂，在肾脏进行递增动态扫描时的灌注技术进行检查。18例患者采用一种技术进行分期，该技术包括在肾门水平进行单次定位动态扫描序列，然后在经股静脉注射造影剂期间进行递增序列扫描。与总体病理分期相比，手臂静脉灌注技术正确分期20例患者（72%），4例患者（14%）分期过低，4例（14%）分期过高。股静脉灌注和单次定位动态扫描技术正确分期11例（61%）患者，3例（17%）分期过高，4例（22%）分期过低。股静脉灌注联合单次定位扫描在显示肿瘤累及肾静脉（正确显示率83.3% vs. 78.6%）、下腔静脉（正确显示率94.4% vs. 89.3%）和淋巴结（正确显示率88.9% vs. 78.6%）方面更准确，但在评估包膜外扩散方面准确性较低（正确显示率77.8% vs. 96.4%）。从单次定位动态序列获得的额外信息非常有价值，以至于第二种技术的这一部分可用于任何肾癌分期的扫描方案中。
