肾透明细胞癌少见影像学表现及相关病理探讨  

The Correlation of Uncommon Imaging Findings with Pathology in Renal Clear Cell Carcinoma

作　　者：刘蓓蒂[1] 陈小华[1] 胡振民[1] 

机构地区：[1]南通大学附属医院放射科,226001

出　　处：《临床放射学杂志》2011年第2期219-222,共4页Journal of Clinical Radiology

摘　　要：目的分析肾透明细胞癌(renal clear cell carcinoma,RCCC)的少见影像学表现,探讨其与病理的关系及临床意义,以提高诊断准确性。资料与方法搜集经手术病理证实的非典型RCCC19例患者资料。均行多层螺旋CT平扫、皮髓交界期和实质期增强扫描,3例行MRI平扫和增强扫描。复习影像及临床资料并与手术病理对照分析。结果 19例RCCC共20个肾脏病灶。19例中表现为少血供7例;囊性5例;多发性RCCC1例(2个病灶);合并外伤致肾周血肿1例;合并肾外病灶2例,其中1例为腹腔畸胎瘤,1例为肺癌;肾癌并显著侧支循环3例,其中1例合并动静脉瘘。结论 RCCC少见影像学表现包括:肿瘤为少血供,囊性,多发病灶,合并肾外肿瘤,肿瘤致侧支循环及动静脉瘘等。认识这些少见影像学表现有利于提高RCCC诊断的准确性,减少误诊。Objective To study the correlation of uncommon imaging findings with pathology in renal clear cell carcinoma（RCCC）,and to improve its diagnostic accuracy.Materials and Methods 19 cases of clear renal cell carcinoma with uncommon imaging findings confirmed by surgery and pathology were collected.All of 19 cases received multi-detector CT plain scanning and dynamic enhancement scanning of corticomedullary phase and parenchymal phase before operation,and 2 cases received MRI plain and post-contrast scanning.Imaging manifestations and clinic data were retrospectively analyzed and compared with surgery and pathology.Results 20 RCCC lesions were found in 19 cases.Insufficient blood supply in 7 cases,cystic form in 6 cases,2 RCCC lesions in 1 case,traumatic perirenal hematoma in 1 case,complicating extrarenal tumor in 2 cases（including teratoma in belly cavity,the other was lung cancer）,3 cases with obvious collateral circulation（arteriovenous fistula in 1 case）.Conclusion The uncommon imaging findings of RCCC include：insufficient blood supply,cystic,multiple,complicating extrarenal tumor,neoplastic collateral circulation and arteriovenous fistula,recognization of the uncommon imaging findings is helpful to improve the diagnostic accuracy of RCCC.

关 键 词：肾 透明细胞癌 体层摄影术 X线计算机 磁共振成像 

分 类 号：R737.11[医药卫生—肿瘤]