Representing 2%-3% of adult cancers, renal cell carcinoma(RCC) accounts for 90% of renal malignancies and is the most lethal neoplasm of the urologic system. Over the last 65 years, the incidence of RCC has increased ...Representing 2%-3% of adult cancers, renal cell carcinoma(RCC) accounts for 90% of renal malignancies and is the most lethal neoplasm of the urologic system. Over the last 65 years, the incidence of RCC has increased at a rate of 2% per year. The increased incidence is at least partly due to improved tumor detection secondary to greater availability of high-resolution cross-sectional imaging modalities over the last few decades. Most RCCs are asymptomatic at discovery and are detected as unexpected findings on imaging performed for unrelated clinical indications. The 2004 World Health Organization Classification of adult renal tumors stratifies RCC into several distinct histologic subtypes of which clear cell, papillary and chromophobe tumors account for 70%, 10%-15%, and 5%, respectively. Knowledge of the RCC subtype is important because the various subtypes are associated with different biologic behavior, prognosis and treatment options. Furthermore, the common RCC subtypes can often be discriminated non-invasively based on gross morphologic imaging appearances, signal intensity on T2-weighted magnetic resonance images, and the degree of tumor enhancement on dynamic contrast-enhanced computed tomography or magnetic resonance imaging examinations. In this article, we review the incidence and survival data, risk factors, clinical and biochemical findings, imaging findings, staging, differential diagnosis, management options and posttreatment follow-up of RCC, with attention focused on the common subtypes.展开更多
目的分析多层螺旋CT(Multislice computed tomography,MSCT)及磁共振成像(Magnetic resonance I m a g i n g,M R I)对肾嫌色细胞癌的(Chromophobe cell renal carcinoma,CCRC)的影像学表现,以加深对该病的认识。资料与方法搜集经手术...目的分析多层螺旋CT(Multislice computed tomography,MSCT)及磁共振成像(Magnetic resonance I m a g i n g,M R I)对肾嫌色细胞癌的(Chromophobe cell renal carcinoma,CCRC)的影像学表现,以加深对该病的认识。资料与方法搜集经手术病理证实的21例肾脏嫌色细胞癌病例,术前全部行MSCT(9例)及MRI(12例)平扫及增强扫描。结果 9例患者接受CT检查,均为单发病灶,2例平扫时可见钙化灶,平扫时病灶呈软组织密度,皮髓质期病灶强化程度均高于肾髓质,但不及肾皮质,7例表现为轻度到中度强化,2例表现为明显强化,其中1例表现为特征性的"8"字征;10例患者接受MR检查,均为单发病灶,8例病灶平扫T1WI上呈等低信号,T2WI及DWI上呈高信号,2例TWI、T2WI上均呈等信号,DWI上呈高信号,4例病灶表现明显强化,3例中度强化,3例轻度强化,MR动态对比增强扫描强化特点与MSCT类似。结论肾嫌色细胞癌MSCT及MRI表现具有一定的特点,综合MSCT及MRI影像表现并分析其临床特征,可以与其他肾脏肿瘤相鉴别。展开更多
文摘Representing 2%-3% of adult cancers, renal cell carcinoma(RCC) accounts for 90% of renal malignancies and is the most lethal neoplasm of the urologic system. Over the last 65 years, the incidence of RCC has increased at a rate of 2% per year. The increased incidence is at least partly due to improved tumor detection secondary to greater availability of high-resolution cross-sectional imaging modalities over the last few decades. Most RCCs are asymptomatic at discovery and are detected as unexpected findings on imaging performed for unrelated clinical indications. The 2004 World Health Organization Classification of adult renal tumors stratifies RCC into several distinct histologic subtypes of which clear cell, papillary and chromophobe tumors account for 70%, 10%-15%, and 5%, respectively. Knowledge of the RCC subtype is important because the various subtypes are associated with different biologic behavior, prognosis and treatment options. Furthermore, the common RCC subtypes can often be discriminated non-invasively based on gross morphologic imaging appearances, signal intensity on T2-weighted magnetic resonance images, and the degree of tumor enhancement on dynamic contrast-enhanced computed tomography or magnetic resonance imaging examinations. In this article, we review the incidence and survival data, risk factors, clinical and biochemical findings, imaging findings, staging, differential diagnosis, management options and posttreatment follow-up of RCC, with attention focused on the common subtypes.
文摘目的分析多层螺旋CT(Multislice computed tomography,MSCT)及磁共振成像(Magnetic resonance I m a g i n g,M R I)对肾嫌色细胞癌的(Chromophobe cell renal carcinoma,CCRC)的影像学表现,以加深对该病的认识。资料与方法搜集经手术病理证实的21例肾脏嫌色细胞癌病例,术前全部行MSCT(9例)及MRI(12例)平扫及增强扫描。结果 9例患者接受CT检查,均为单发病灶,2例平扫时可见钙化灶,平扫时病灶呈软组织密度,皮髓质期病灶强化程度均高于肾髓质,但不及肾皮质,7例表现为轻度到中度强化,2例表现为明显强化,其中1例表现为特征性的"8"字征;10例患者接受MR检查,均为单发病灶,8例病灶平扫T1WI上呈等低信号,T2WI及DWI上呈高信号,2例TWI、T2WI上均呈等信号,DWI上呈高信号,4例病灶表现明显强化,3例中度强化,3例轻度强化,MR动态对比增强扫描强化特点与MSCT类似。结论肾嫌色细胞癌MSCT及MRI表现具有一定的特点,综合MSCT及MRI影像表现并分析其临床特征,可以与其他肾脏肿瘤相鉴别。
