摘要
目的探讨T1期肾癌部分切除术前和术后随访MRI检查的临床价值。方法回顾性分析53例肾癌部分切除患者术前MRI检查病灶位置、大小、假包膜、有肾周浸润、肾静脉瘤栓和远处转移者资料并进行临床分期及与手术病理结果对照。术后最后一次MRI随访术区愈合情况、有无复发和远处转移。结果 53例手术病理证实均为T1期肾癌。病灶位置、大小、假包膜、有无肾周围浸润、肾静脉瘤栓和远处转移,与手术病理结果对照基本符合。术后MRI术区呈三角形或楔形,增大和无变化术区T2WI和DWI信号混杂,部分有分隔;缩小者T_1WI、T_2WI和DWI均呈低信号。术后随访无1例发生局部复发或远处转移。结论 MRI检查在T1期肾癌腹腔镜肾部分切除术前准确诊断和分期,把握适应证和术式选择及术后随访中具有重要的临床价值。
Objective To explore the clinical value of MRI in the preoperative diagnosis of T1 stage renal cancer and in postoperative follow-up after partial nephrectomy. Methods Fifty-three patients（ 46 males,7 females,aged 24 to 67 years old,mean age 49. 96 ± 10. 06 years） were studied retrospectively. All patients were performed MR examination before operations,and the lesion＇s location,size,pseudo-capsule,peripheral infiltrating changes,tumor embolus in renal veins and metastasis were all recorded and comparied with pathologic results. As for the postoperative follow-up up-to-date,all patients received unenhanced MR scan in which 39 patients also received contrast-enhanced scan. And the operative region healing,recurrence and metastasis were recorded in every case. Moreover,all cases underwent partial nephrectomies. Results Fifty-three T1 stage renal cancers were analyzed preoperatively,in which 27 lesions were located in left kindy,and 30 in right side,what＇s more,4 cases were bilateral. The lesion＇s location with renal hilum distance was 24 - 56 mm,average of 37 mm. Of all the cases,50（ 50 /57,87. 7%） were peripheral type,7（ 7 /57,12. 3%） were central type. The lesion size ranged from 8 mm to 60 mm,with an average of 30 mm,and 3（ 3 /57 5. 3%） lesions＇ s size were greater than 40 mm. 44（ 44 /57,77. 2%） lesions were bulged to cortex,while the other 13（ 13 /57,22. 8%） lesions not. Also,51（ 51 /57,89. 5%） had pseudo-capsule,6（ 6 /57,10. 5%） not. All the cases showed no renal vein tumor embolus,no lymphadenopathy in the perirenal and retroperitoneum space,and the perirenal fat space were all clear. The shape of the postoperative area appeared trangles or wedge-shaped in MRI followed up. Compared to the preoperation,the postoperative area of the original lesion showed enlarged in 7 cases（ 7 /57,12. 3%）,no change in 9（ 9 /57,15. 6%）,and diminution in 41（ 41 /57,71. 9%）. The enlarged area and the similar area all showed heterogenous signal intensity on T2 WI and DWI,with se
出处
《医学影像学杂志》
2016年第2期288-291,共4页
Journal of Medical Imaging
基金
国家自然科研基金课题面上项目(编号:81471641)
