摘要
目的探讨肾嗜酸细胞腺瘤(RO)CT及MRI的表现特点,为RO的临床诊断提供参考。方法回顾性分析2011年2月—2017年7月解放军福州总医院经术后病理检查确诊为RO的24例患者的临床资料,其中男12例、女12例,年龄36~71(55.2±10.4)岁。患者术前行CT平扫及增强三期扫描,或行MRI平扫及增强扫描,观察病灶的部位、大小、形态、边界,坏死、囊变及星状瘢痕,平扫及多期增强扫描病灶强化情况,以及有无肾周组织侵犯及淋巴结转移。结果24例患者中22例行CT检查,5例行MRI检查。共发现25个病灶,23例为单侧单发,1例为双侧单发;9例位于右肾,16例位于左肾;病灶最大径(3.4±1.2)cm。CT检查22例23个病灶,平扫13例病灶呈等密度,2例可见钙化,3例见囊状低密度影,12例见星状瘢痕;增强扫描均强化明显,动态增强曲线呈"速升缓降"型。MRI检查5例5个病灶,平扫5例T1WI呈等、低信号,T2WI呈混杂稍高信号,DWI呈混杂高信号;增强扫描1例见囊状低密度影,1例见星状瘢痕。所有病例肾周脂肪间隙清晰,肾静脉及下腔静脉内均未见瘤栓,肾门及腹主动脉旁均未见肿大淋巴结。结论RO的CT及MRI表现具有一定的特征性,术前提高对RO的认识,可减少不必要的根治性肾切除术,具有重要的临床应用价值。
Objective To investigate the CT and MRI features of renal oncocytoma, so as to provide reference for the clinical diagnosis of renal oncocytoma. Methods The imaging features of 24 patients with renal oncocytoma by surgical pathology in Fuzhou General Hospital from February 2011 to July 2017 were analyzed retrospectively. There were 12 males and 12 females, with age 36-71 (55.2±10.4) years. Preoperative CT scanning and enhanced scanning, or MRI scanning and enhanced scanning were used to evaluate the location, size, morphology, border, necroses and cystic degeneration, stellate scar and enhancement features in different phases, as well as renal tissue invasion and lymph node metastasis. Results In 24 patients, 22 routine CT tests and 5 routine MRI tests were performed. There were 25 lesions, 1 case revolved in bilateral renal, which was solitary while 23 cases were unilateral solitary lesions. Among the 9 cases in the right kidney and 16 cases in the left kidney, the largest diameter was (3.4±1.2) cm. CT scanning of 22 cases of 23 lesions. On pre-contrast CT scanning, the 13 tumors showed isodensity and calcification were observed in 2 cases, small cystic low density was observed in 3 cases and stellate scar was seen in 10 cases. On multiple phase contrast scanning, most cases appeared obvious enhancement, which displayed a steep increase and then progressive washout pattern for dynamic enhancement curve. On MRI, 5 cases of 5 lesions. All 5 tumors showed iso-hypo signal intensity on T1WI and heterogeneously hyper-intensity on T2WI and DWI. The small cystic low density was observed in 1 case and stellate scar was seen in 1 case. All the lipid spaces around the kidney were clear. No tumor plug was found in renal vein and inferior vena cava. No enlarged lymph nodes were found beside renal hilum and abdominal aorta. Conclusions The CT and MRI imaging manifestation of renal oncocytoma has certain characteristics. It could improve the understanding of this disease and reduce unnecessary radical nephrectomy, which has
作者
张钰
陈自谦
付丽媛
向娟
Zhang Yu;Chen Ziqian;Fu Liyuan;Xiang Juan(Department of Medical Imaging, Fuzhou Teaching Hospital of Bengbu Medical College, Fuzhou General Hospital of Nanjing Military Region, Fuzhou 350025, China)
出处
《中华解剖与临床杂志》
2018年第6期473-477,共5页
Chinese Journal of Anatomy and Clinics
