泌尿系少见肿瘤和肿瘤样病变的螺旋CT诊断  

Spiral CT Diagnosis of Unusual Tumors and Tumor-like Lesions of Urinary System

作　　者：李葆青[1] 陈巨坤[2] 张祥[1] 

机构地区：[1]北京市石景山医院放射科,100043 [2]解放军总医院放射科,北京100853

出　　处：《中国医学影像学杂志》2007年第4期287-291,共5页Chinese Journal of Medical Imaging

摘　　要：目的:探讨泌尿系少见肿瘤和肿瘤样病变的螺旋CT表现。材料和方法:回顾性分析经手术病理证实的15例泌尿系少见肿瘤和肿瘤样病变的CT表现。结果:乳头状肾细胞癌4例,发生在肾皮层和近肾窦各2例,CT表现均呈囊实性、无腹膜后淋巴结转移和下腔静脉瘤栓,其中2例伴肾盂积水和结石。多房性透明细胞肾细胞癌4例,其中呈不规则厚壁2例、囊性部分较大实性部分较小1例、薄壁伴壁结节1例。嫌色细胞肾细胞癌2例,CT表现为肾内实性肿块,最大径分别为2.0cm和2.5cm,边缘较光整,密度均匀,肾皮质早期增强较正常皮质低。黄色肉芽肿性肾盂肾炎2例,CT均表现为肾盂内肿块边界不清,呈囊实性,伴结石及肾实质空洞。膀胱憩室口周围癌变1例,CT表现为膀胱憩室口周围不规则增厚,轻度增强;膀胱外翻癌变1例,CT表现为膀胱向前下翻出盆腔,耻骨联合部分分离,膀胱前壁乳头状结节,轻度增强。膀胱淀粉样变性1例,CT表现为膀胱右后壁不规则增厚,呈多个乳头状突入膀胱腔内,无增强。结论:螺旋CT能够清晰地显示泌尿系少见肿瘤和肿瘤样病变的部位、形态和增强特点,对其诊断和鉴别诊断有重要价值。Purpose： To explore the Spiral CT（ SCT ） characteristics of unusual tumors and tumor-like lesions of urinary system. Materials and Methods： The SCT characteristics of papillary renal cell carcinoma （n =4）, multilocular clear cell renal cell carcinoma （n =4）, chromopbobe renal cell carcinoma （ n = 2 ）, xanthogranulomatous pyelonephritis （ n = 2 ） , malignant degeneration of bladder diverticulum （ n = 1 ）, malignant degeneration of extrophia bladder（ n = 1 ） and amyloidosis of bladder（ n = 1 ）, were analyzed retrospectively. Results： Of 4 papillary renal cell carcinomas, SCT showed the turmas which raised in renal cortex or adjacent renal sinus in 2 eases, respectively. On SCT all 4 tumors appeared as a cyst-solld mass, with obstructed nephrydrosis and stones in 2 cases, without any retroperitoneal lymphadenopathies and tumor emboli in the inferior vena cava in in 4 cases. Of 4 multilocular clear cell renal cell carcinomas, SCT displayed the cystic mass with irregularly thickened wall in 2 cases, a big cyst with small solid part in 1 case, and a cystic thinner wall with mural enhanced nodule in 1 case. SCT depicted two chromophobe renal cell carcinomas with well margins, homogeneous density, and less enhancement than normal renal cortex , and a diameter of 2.0cm and 2.5cm respectively; SCT showed soft tissue masses with poor borders in the renal pelvis,and with nephrydrosis and stones and cavities in renal parenchyma of 2 xanthogranulomatous pyelonephritis . SCT showed the malignant degeneration surrounding the entrance of the vesical diverticulum that was irregularly thickened and enhanced in lease. On SCT, the malignant degeneration of extrophia of the bladder had a enhanced papillary nodule in the anterior wall outside pelvis in 1 case. SCT appeared the amyloidosis of the bladder as multiple non-enhanced , irregular nodules in the right posterior wall in 1 case. Conclusion： SCT can clearly display the location, morpbologic and contrast enhancement characteristics and has a

关 键 词：乳头状肾细胞癌 嫌色细胞肾细胞癌 多房性透明细胞肾细胞癌 黄色肉芽肿性肾盂肾炎 膀胱憩室口癌变 膀胱外翻癌变 膀胱淀粉样变性 螺旋CT 

分 类 号：R816.7[医药卫生—放射医学]