Challier E, Bellin M F, Fadel Y, Richard F, Ghebontni L, Grellet J
Service de Radiologie, Hôpital Pitié-Salpêtrière, Paris.
Prog Urol. 1997 Jun;7(3):484-95.
The increased incidence of detection of small renal tumours, less than or equal to 3 cm in diameter, is related to the generalization and improvement of radiological techniques. Many asymptomatic renal tumours are discovered by ultrasonography and computed tomography. Medical imaging is now able to identify simple cysts (morphological characters, absence of blood supply), angiomyolipomas (demonstration of the fatty contingent) and other solid renal tumours (tumour enhancement on computed tomography). Plain, followed by postcontrast CT looking for contrast enhancement of the lesions is the examination of choice in this context. MRI with Gadolinium injection looking for neoplastic enhancement can be useful in doubtful cases. Medical imaging is able to reliably demonstrate the vascular nature of solid lesions, but cannot distinguish between renal cancer, oncocytoma or another benign solid tumour. Medical imaging allows precise preoperative mapping when partial nephrectomy is envisaged.
直径小于或等于3厘米的小肾肿瘤检出率的增加与放射技术的普及和改进有关。许多无症状肾肿瘤通过超声检查和计算机断层扫描被发现。医学成像现在能够识别单纯性囊肿(形态特征、无血供)、肾血管平滑肌脂肪瘤(脂肪成分的显示)和其他实性肾肿瘤(计算机断层扫描上肿瘤强化)。在此情况下,先进行平扫,然后进行增强CT以寻找病变的强化是首选检查。注射钆剂的MRI以寻找肿瘤强化在可疑病例中可能有用。医学成像能够可靠地显示实性病变的血管性质,但无法区分肾癌、嗜酸细胞瘤或其他良性实性肿瘤。当考虑进行部分肾切除术时,医学成像可进行精确的术前定位。