摘要
目的通过CT扫描探讨血供充足乏脂肪肾脏错构瘤的特点,提高鉴别其与肾透明细胞癌的诊断准确率。方法回顾性分析我院24例术后证实的血供充足的乏脂肪肾脏错构瘤患者(共25个肿瘤)并进行病理学比较研究。结果本组24例错构瘤的患者均未出现血尿。96例确诊为肾透明细胞癌的患者,14例有血尿(14.6%)。CT扫描分析显示,20例肿瘤具有类似的密度,其中5例密度较高,1例有少量钙化点(4%),9例未见脂肪组织,16例经CT扫描可见脂肪组织斑点;增强扫描显示所有肿瘤肾皮髓期明显增强,20例肿瘤早期明显不均匀强化,另5例均匀延迟增强;19例患者手术移除错构瘤,6例患者由于误诊为肾癌,导致单侧肾移除,肿瘤严重累及肾实质及肾窦;经病理分析,25例属于肾错构瘤,96例肾透明细胞癌患者中,64例肿瘤密度相对较低,29例等密度,3例较高密度;14例钙化(14.6%),未见脂肪组织。CT增强扫描表明,69例肾癌表现为肾皮髓质期显著强化,呈"快进快出"异常模式。此外,27例表现为缓慢延迟增强。结论通过薄层CT确定脂肪组织的位置有利于鉴别血供充足乏脂肪肾脏错构瘤与肾透明细胞癌。
Objective To investigate the features of minimal fat renal angiomyolipoma with sufficient blood supply by CT scan and to improve the diagnostic accuracy in differentiating it from clear cell renal carcinoma. Methods 24 cases of patients with postsurgery confirmed angiomyolipoma with sufficient blood supply（total of 25 tumors） in our hospital were retrospectively analyzed and were pathologically compared and studied. Results Among the 24 patients diagnosed with angiomyolipoma, there was no patients with bloody urine. Of the 96 patients diagnosed with clear cell renal cancer, 14 had bloody urine（14.6%）. CT scan analysis showed 20 tumors were of similar density, and 5 of them were of higher density. Only one tumor had a few dots of calcification（4%）. CT scan showed thaty adipose tissue was not visible in 9 tumors, while 16 tumors had visible dots of adipose tissue. Intensive scanning indicated that all of the tumors showed a strong enhancement in the renal corticomedullary phase. 20 tumors had significant heterogeneous enhancement in the early phase, while another 5 cases had homogenous prolonged enhancement. 19 patients had surgery to remove the angiomyolipomas, while 6 patients had single side kidney removal because of misdiagnosis for renal cancer and the renal parenchyma and sinus were severely compromised by tumors. 25 cases were classified as renal angiomyolipoma by pathological analysis. Within the 96 cases of clear cell renal cancer, 64 tumors were of relatively low density, 29 tumors of equal density, and 3 cases of relatively higher density. 14 of the tumors had calcification（14.6%）, and none of them had visualized adipose tissue. Enhanced CT scans indicated that 69 cases of renal cancer showed significant enhancement in the renal corticomedullary phase, with the abnormal pattern of ＂fast-in-and-fast-out＂. Besides, 27 cases had slow and prolonged enhancement. Conclusion The key to differentiating them is to identify the adipose tissue within the tumor. Therefore, it is helpful to use th
出处
《中国CT和MRI杂志》
2015年第12期68-70,共3页
Chinese Journal of CT and MRI
关键词
肾癌
错构瘤
乏脂肪
肾透明细胞癌
CT扫描
Renal Tumor
Angiomyolipoma
Minimal Fat
Clear Cell Renal Carcinoma
CT Scan
