摘要
目的分析肾上皮样血管平滑肌脂肪瘤(EAML)的影像学表现,进一步提高诊断准确性。方法回顾性分析经手术病理证实的19例EAML患者的影像学资料,11例行CT平扫及增强检查,7例仅行CT增强检查,1例行CT增强检查和MRI平扫及增强检查。结果肾EAML 19例共21个病灶,2例双侧发病,瘤体最大径1.8～25.2 cm,平均6.5 cm;多数病灶突出于肾轮廓外(19/21)且与肾实质分界清晰(17/21)。11例CT平扫检出12个病灶,8个病灶密度不均匀,其中7个病灶内含脂肪成分,1个病灶内示囊变坏死区;4个病灶密度均匀且高于肾实质;2例出现肾包膜下血肿。21个病灶行CT增强扫描,动脉期14个病灶不均匀明显强化,内示粗大血管影,静脉期血管影仍可见;13个病灶强化方式为快进快出,8个病灶为持续性强化。1例行MRI,T1WI及T2WI呈混杂信号,病灶局部在反相位像上信号强度较同相位像明显下降。结论影像学表现结合临床资料对正确诊断肾EAML有重要价值,但最后确诊仍需依赖病理。
Objective To explore the imaging features of renal epithelioid angiomyolipoma（EAML）,and to improve the diagnostic accuracy.Methods The clinical materials and image findings of 19 cases with renal EAML proved by pathologies were analysed retrospectively.11 patients underwent both non-enhanced and contrast-enhanced CT scan,7 patients only performed enhanced CT scan,and 1 patient underwent enhanced CT scan as well as MRI.Results 21 masses were found in 19 cases,mean of the maximum diameter was 6.5cm（rang1.8 to 25.2）;most masses had clear margin（17/21） and grew out of the renal contour（19/21）.12 masses were found on unenchanced CT scan,8 masses displayed heterogeneous density,and 7 masses contained the density of fat,1 mass had the area of cystic change and necrosis;the density of 4 masses were homogeneous and higher than renal parenchyma;2 cases had subcapsular hematomas.On enhancement CT scan（21 masses）,14 masses appeared as obviously unhomogeneous enhancement in artery phase-with spotty and striped hyperdensity areas,representing enlarged malformation vessels,which also could be found in vein phase.The enhanced mode of the masses was washout pattern（13/21）or prolonged enhancement patter（8/21）.On MRI,the mass demonstrated mixed signal on both T1WI and T2WI,and the signal intensity of part of the mass dropped significantly from in phase to opposed-phase,and heterogeneous enhancement.Conclusion The imaging findings of EAML in combined with clinical data is important in making a correct diagnosis preoperatively,however,the final diagnosis also dependents on biopsy.
出处
《临床放射学杂志》
CSCD
北大核心
2013年第5期684-688,共5页
Journal of Clinical Radiology
基金
江苏省自然科学基金资助项目(编号:BK2010178)
