摘要
目的分析后肾腺瘤临床特点及MR影像学表现。材料与方法回顾性分析解放军总医院第一医学中心2013年1月至2019年12月期间,病理证实且具有完整MRI影像的肾脏后肾腺瘤病例,分析其临床特点以及MR影像学表现。2名影像医师共同对肿瘤病灶的MRI影像表现进行观察。结果符合纳入条件的后肾腺瘤共有11例。其中男性3例,女性8例,年龄26~66(38.5±12.3)岁。所有病灶均为单发,大小为(3.7±1.7)cm。10例患者为查体发现,2例具有红细胞增多症,10例采取肾部分切除术,1例为根治性肾切除术。11例病灶T2WI上边界清晰,7例具有外生或部分外生特点,7例病灶内缘毗邻肾窦,T2WI上2例病灶存在完整假包膜征象,4例具有不完整假包膜征象,5例无假包膜征象,8例病灶显示囊变坏死样表现,2例出血,T2WI上9例表现为等低信号,8例信号不均匀,DWI上8例为边缘高信号,3例为均匀高信号,ADC图上9例为边缘低信号,2例为均匀低信号,预扫T1WI上9例为低信号。增强扫描各时相病灶信号强度低于肾皮质,并表现为渐进性强化。结论后肾腺瘤中青年女性好发,单侧单发,无明显临床症状,少数可有红细胞增多症。后肾腺瘤MR影像学特点为病灶外生为主,内缘毗邻肾窦,T2WI等低信号,无假包膜或假包膜不完整,DWI环形扩散受限,囊变坏死可见,出血少见,无脂质脂肪,轻度进行性强化。上述MR影像特点有助于临床医师和影像医师对后肾腺瘤的精确诊断。
Objective:To document the clinical characteristics and MR imaging features of metanephric adenoma(MA).Materials and Methods:Pathologically-proven MAs with complete MR protocol were retrospectively analyzed between January 2013 and December 2019.The clinical information and MR imaging features were reviewed.Two experienced radiologists in consensus observed the MR imaging features of all the cases.Results:Eleven cases of MA(3 males,8 females)were enrolled in this study with age of(38.5±12.3)years old.All lesions were solitary.The diameter was(3.7±1.7)cm.Ten lesions were detected during routine health checkup.Two patient presented polycythemia.Ten patients underwent partial nephrectomy,and one radical nephrectomy.All lesions were well-defined,7 lesions demonstrated exophytic growth,and 7 lesions were adjacent to the renal sinus.Two lesions showed complete pseudocapsule on T2WI and 4 incomplete pseudocapsule.Eight lesions showed cystic degeneration or necrosis and 2 hemorrhage.On T2WI 9 lesions showed inhomogeneous hypointensity,all lesion hyperintenisty on DWI,8 of which showed rim hyperintensity,while on ADC map.All lesions showed hypointensity,9 of which rim hypointensity.On T1WI 9 lesions showed hypointensity.On contrast-enhanced imaging,the signal intensity of MA lesions was lower than that of renal cortex,and MR lesions demonstrated progressive enhancement pattern.Conclusions:MA is common in young and middle-aged women,with unilateral single mass and no obvious clinical symptoms.The main MR imaging features are mainly exophytic,adjacent to renal sinus at the inner edge,hypointensity on T2WI,no or incomplete pseudocapsule,rim diffusion restriction on DWI,visible cystic degeneration and necrosis,rare hemorrhage,no lipid or fat,and mild progressive enhancement.The characteristics of MR imaging can help clinicians and radiologists to accurately diagnose MA.
作者
石家源
许伟
袁静
白旭
康欢欢
崔梦秋
叶慧义
王海屹
SHI Jiayuan;XU Wei;YUAN Jing;BAI Xu;KANG Huanhuan;CUI Mengqiu;YE Huiyi;WANG Haiyi(Department of Radiology,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Radiology,Shaanxi Sengong Hospital,Xi'an 710300,China;Department of Pathology,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China;Department of Radiology,the Fifth Medical Center of Chinese PLA General Hospital,Beijing 100039,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2021年第7期64-68,共5页
Chinese Journal of Magnetic Resonance Imaging
基金
国家自然科学基金项目(编号:81971580)。
关键词
肾脏
肾脏肿瘤
磁共振成像
后肾腺瘤
诊断
kidney
kidney neoplasm
magnetic resonance imaging
metanephric adenoma
diagnosis
