肾脏癌肉瘤的影像表现  

Imaging Features of Renal Carcinosarcoma

作　　者：邝菲[1] 钟群[2] 聂枚[2] 

机构地区：[1]解放军第174医院影像科,厦门361003 [2]南京军区福州总医院放射科,350025

出　　处：《临床放射学杂志》2010年第10期1356-1359,共4页Journal of Clinical Radiology

摘　　要：目的探讨肾脏癌肉瘤的影像表现。资料与方法回顾性分析经手术病理证实的10例癌肉瘤的影像表现。结果 MRI检查10例,肿瘤体积较大,信号明显不均匀,9例实性成分T1WI、T2WI均表现为等低混杂信号,1例T1WI呈略低、T2WI呈等信号;增强扫描9例表现为"花瓣"状强化,1例为轻度不均匀强化伴内部间隔轻度强化;扩散加权成像(DWI)显示实性部分呈明显高信号,坏死区呈略高信号。CT检查5例,均呈等及略低密度,1例肿瘤内部可见"点"状钙化。DSA检查1例,供血动脉增粗不明显,可见轻中度肿瘤边缘区"瘤染色"。结论肾癌肉瘤体积较大,瘤内多发坏死,实性成分T2WI呈等或略低信号,增强扫描强化程度低于正常肾实质并呈"花瓣"状及分隔强化,是其诊断要点;多种检查方法的联合应用有助于提高肾脏癌肉瘤的确诊率。Objective To discuss the imaging features of renal carcinosarcoma. Materials and Methods The imaging data of 10 cases with renal carcinosarcoma pathologically proved were retrospectively analyzed. Results All of the 10 cases were performed by MRI,the tumors showed a huge mass with markedly heterogeneous signal intensity. Heterogeneous intensity signal of solid mass was seen on T1WI and T2WI in 9 cases,1 case appeared slight hypointense on T1WI and isointense on T2WI;9 cases showed ＂petal-like＂ enhancement,1 case showed slightly heterogeneous septum enhancement;On DWI the solid mass appeared significant hyperintense and the necrosis region appeared slight hyperintense. 5 cases were performed by CT,all the tumors showed isodensity or slight hypodensity and 1 case appeared punctiform calcification.1 case was performed by DSA which showed slight to moderate stains in the tumor edge by unenlarged blood supply arteries. Conclusion The image features of renal cacinosarcoma are a huge mass with necrosis and isointense or slight hypointense on T2WI in solid mass,and all of them showed ＂petal-like＂ and septum enhancement which is lower than the enhanced normal renal parenchyma,the combination of multiple modalities can improve the diagnostic accuracy of renal carcinosarcoma.

关 键 词：肾脏癌肉瘤 磁共振成像 扩散加权成像 体层摄影术 X线计算机 

分 类 号：R737.11[医药卫生—肿瘤]