Mauro M A, Wadsworth D E, Stanley R J, McClennan B L
AJR Am J Roentgenol. 1982 Dec;139(6):1135-8. doi: 10.2214/ajr.139.6.1135.
Accurate preoperative staging of renal cell carcinoma determines which patients may benefit from surgery and influences the surgical approach to potentially curable lesions. Recently, computed tomography has been shown to be as accurate as angiography for staging renal tumors, suggesting that angiography may be limited to those cases where clarification of equivocal computed tomographic findings or additional staging information would alter the therapy. To test this hypothesis, the radiographic evaluation of 42 patients with renal cell carcinoma was reviewed. Of the 42 patients, 24 (57%) were examined by computed tomography alone, while 18 (43%) had angiographic and computed tomographic examinations (nine venograms and 11 arteriograms). Seven of the nine venograms obtained for diagnosis or staging added additional information or clarified an equivocal computed tomographic finding, but none of the 11 arteriograms added significant diagnostic information. Venograms were particularly useful in patients with bulky right-sided lesions. Computed tomographic staging of renal cell carcinoma can be accepted by urologists and has, in fact, reduced the use of routine preoperative angiography in our medical center.
肾细胞癌准确的术前分期能确定哪些患者可能从手术中获益，并影响对潜在可治愈性病变的手术方式。最近研究表明，计算机断层扫描（CT）在肾肿瘤分期方面与血管造影术一样准确，这表明血管造影术可能仅限于那些CT检查结果不明确需要进一步明确或需要额外分期信息以改变治疗方案的病例。为验证这一假设，回顾了42例肾细胞癌患者的影像学评估资料。42例患者中，24例（57%）仅接受了CT检查，而18例（43%）同时接受了血管造影和CT检查（9例静脉造影和11例动脉造影）。用于诊断或分期的9例静脉造影中有7例提供了额外信息或明确了CT检查不明确的结果，但11例动脉造影均未提供重要的诊断信息。静脉造影对右侧较大病变的患者尤其有用。肾细胞癌的CT分期已被泌尿外科医生所接受，实际上在我们医疗中心已减少了术前常规血管造影的使用。
