Abstract：Objective: To explore the clinical value of split bolus multidetector computed tomographic(MDCT) enhanced examination in clear cell renal carcinomas(ccRCC). Methods: 120 patients suspected of kidney tumor by ultrasound or physical examination were divided into two groups randomly. The experimental group contained 60 cases who were given split bolus two phase CT enhanced scanning, the control group also contained 60 cases who had routine three phase enhanced scanning. The results of surgical operation were correlated with pathology. Ninety cases were ccRCC confirmed by pathology. Among these 90 cases, 44 cases were in the experimental group, 46 cases were in the control group. The degree of contrast of the tumor and the normal kidney in each phase were compared and also the radiation dosage were calculated. Results: ①Compared the mean CT value of the ccRCC of the experimental group in the cortico-medullary phase(CMP), nephrographic-excretory phase(N-EP) and the CMP, N-EP of the control group had no significant difference(P=0.064, P=0.105); Compared the mean CT value of N-EP in ccRCC of the experimental group and the NP of that in the control group had significant difference(P=0.000). ②The mean CT value in the CMP of the normal kidney in the experimental group compared with that of the control group had no significant difference(P=0.105). The CT value in the N-EP of the normal kidney in the experimental group compared with the mean CT values of nephrographic phase(NP), and excretory phase(EP) of the normal kidney in the control group had significant differences(P=0.000, P=0.001). ③In the experimental group, the average effective radiation dosage was 15.25 mSv. There was 30% less than the radiation effective dose of the control group. Conclusion: The split bolus MDCT enhancement examination can accurately diagnosed ccRCC, and at the same time, the effective dosage decreased obviously. There is important clinical application value of the method.
2014, Vol. 25 
