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1、Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,11/7/2009,#,單擊此處編輯母版標題樣式,單擊此處編輯母版文本樣式,第二級,第三級,第四級,第五級,*,腎細胞癌的,CT,表現(xiàn),CT Features and Staging of Renal Carcinoma,李振輝,,,Lee Zhenhui,昆明醫(yī)科大學第三附屬醫(yī)院放射科,Radiology Department,Third,Affiliated H
2、ospital,KMMU,云 南 省 腫 瘤 醫(yī) 院 放 射 科,Radiology Department,Yunnan Tumor Hospital,Part IIRCC,的臨床分期及,CT,影像價值,腎細胞癌的,Robson,分期,分 期,標 準,I,期,腎癌癌細胞位于腎包膜內,II,期,腎癌癌細胞侵入腎周圍脂肪,在仍然局限于腎周圍筋膜內,III,期,腎癌癌細胞侵犯腎靜脈或局部淋巴結,有,/,無下腔靜脈、腎周圍脂肪受累,a,期,腎癌癌細胞侵犯腎靜脈或下腔靜脈,b,期,區(qū)域性淋巴結受累,c,期,同時累及腎靜脈、下腔靜脈、淋巴結,(,同側腎上腺,),IV,期,腎癌癌細胞遠處轉移或侵犯鄰近器官,
3、a,期,腎癌癌細胞侵犯除腎上腺外的鄰近器官,b,期,腎癌癌細胞遠處轉移,腎細胞癌的,Robson,分期,腎細胞癌的,TNM,分期,分期,標準,分期,標準,原發(fā)腫瘤,(T),區(qū)域淋巴結(,N),TX,原發(fā)腫瘤無法評估,NX,區(qū)域淋巴結無法評估,T0,無原發(fā)腫瘤的證據(jù),N0,沒有區(qū)域淋巴結轉移,T1,腫瘤局限于腎臟,最大徑,7cm,N1,有區(qū)域淋巴結轉移,T1a,腫瘤最大徑,4cm,T1b,4cm7cm,M0,無遠處轉移,T2a,7cm10cm,T3,腫瘤侵及腎靜脈或除同側腎上腺外的腎周圍組織,但未超過腎周圍筋膜,T3a,腫瘤侵及腎靜脈或侵及腎靜脈分支的腎段靜脈,(,含肌層的靜脈,),或侵犯周圍脂
4、肪和,(,或,),腎竇脂肪,(,腎孟旁脂肪,),,但是未超過腎周圍筋膜,T3b,腫瘤侵及橫膈下的下腔靜脈,T3c,腫瘤侵及橫膈上的下腔靜脈,T4,腫瘤侵透腎周筋膜,包括侵及鄰近腫的同側腎上腺,腎細胞癌的,TNM,分期,-T1a,腎細胞癌的,TNM,分期,-T1a,腎細胞癌的,TNM,分期,-T1b,腎細胞癌的,TNM,分期,-T1b,腎細胞癌的,TNM,分期,-T2,T2a,T2b,腎細胞癌的,TNM,分期,-T2,T2a,T2b,腎細胞癌的,TNM,分期,-T3a,侵及腎周,侵及腎竇,侵及腎,V,腎細胞癌的,TNM,分期,-T3a,侵及腎周,侵及腎,V,腎細胞癌的,TNM,分期,-T3b/c
5、,T3b,侵及膈下下腔靜脈,T3c,侵及膈上下腔靜脈,腎細胞癌的,TNM,分期,-T3c,腎細胞癌的,TNM,分期,-T4,T4,侵及同側腎上腺,T4,侵透腎周筋膜,腎細胞癌的,TNM,分期,-T4,T4,侵及同側腎上腺,T4,侵透腎周筋膜,腎細胞癌的,TNM,分期,-N,腎細胞癌的臨床分期,-M,部位,%,肺部,75,軟組織,35,骨骼,20,肝臟,20,腎上腺,19,皮膚,8,CNS,8,CT,影像在,RCC,分期的價值,Tumors Confined Within the Renal Capsule,Perinephric Spread of Tumor,Imaging of the I
6、psilateral Adrenal Gland,Venous Spread of Tumor,Regional Lymph Node Metastases,Local Extension and Distant Metastases,CT,影像在,RCC,分期的價值,Tumors Confined Within the Renal Capsule,腫瘤局限性在腎內(纖維囊內),CT,影像在,RCC,分期的價值,Perinephric Spread of Tumor,腫瘤侵及腎周,CT,影像在,RCC,分期的價值,Imaging of the Ipsilateral Adrenal Gland,觀察同側腎上腺,CT,影像在,RCC,分期的價值,Venous Spread of Tumor,腫瘤的靜脈擴散,CT,影像在,RCC,分期的價值,Venous Spread of Tumor,腫瘤的靜脈擴散,CT,影像在,RCC,分期的價值,Venous Spread of Tumor,腫瘤的靜脈擴散,CT,影像在,RCC,分期的價值,Regional Lymph Node Metastases,區(qū)域淋巴結轉移,