小肾癌与肾血管平滑肌脂肪瘤的影像诊断  

Imaging diagnosis of small renal cell carcinoma and renal angiomyolipoma

作　　者：张广源[1] 李志伟[2] 梁碧玲[2] 

机构地区：[1]开平市中心医院放射科,广东开平529300 [2]中山大学第二附属医院放射科

出　　处：《实用放射学杂志》2011年第11期1703-1706,共4页Journal of Practical Radiology

摘　　要：目的探讨直径〈3cm的小体积肾癌（renalcellcarcinoma，RCC）及肾虹管平滑肌脂肪瘤（renalangiomyolipoma，RAML）的CT及MRI征象。方法回顾性分析经手术病理证实的47例，包括RCC24例；RAML23例，肿瘤直径均小〈3cm。所有病例均行MRI平扫和增强扫捕，其中RCC组中8例、RAML组中有10例同时进行了CT平扫及增强检查。结果所有病例均被MR检出。RCC组：18例边界清楚，6例边界不清，病理显示17例有假包膜，假包膜为肿块周围带状低信号，MR显示13例（76．5％），T2WI／SPIR显示率较高。增强扫描肿块多为不均匀明碌强化，周嗣假包膜无强化，肿块强化呈“快进快出”特性曲线，以皮质期强化明显。其中1例为囊性，增强扫描见囊壁强化。RAML组21例边界清楚，2例边界欠清，病理显示19例有脂肪成分，MR显示18例（94．7％），增强扫描病变未见强化或轻中度强化。其强化峰值出现较晚，以实质期强化为主。结论小肾癌与肾血管平滑肌脂肪瘤的不同影像表现，取决于其组织学成分。Objective To study CT and MRI findings of small renal cell carcinoma （RCC） and renal angiomyolipoma（RAMI.）. Methods 24 cases with small RCC（〈3 cm in size） and 23 cases with RAML confirmed by operation and pathology were retrospectively analysed. All cases underwent un-contrast and contrast-enhanced MRI,8 cases with RCC and 10 cases with RAML underwent plain and contrast-enhanced CT scan simuhaneously. Results The renal masses in all cases were detected by MRI. The imaging appearances of RCC included pseudocapsule（ 13 cases）, boundary well-defined （ 18 cases） or non defined （ 6 cases）. The pseudocapsules were hyperintens on MR images and no enhancement indicated at contrast enhanced scan. The masses were mostly inhomogeneous enhancement with the fast into fast out density-time curve. There was cystic in 1 case. The masses of RAML were well-defined in 21 cases and un defined in 2 cases,fat content could be demonstrated in 19 cases by histology and in 18 cases by MRI （94. 7%）. In RAML,the lesions were no or slight-middle enhancement, the enhanced peak was late. Conclusion The different imaging appearances of RCC and RAML were depended on the distinction of histologic components of tile tumors.

关 键 词：肾脏 肾癌 肾血管平滑肌脂肪瘤 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] R814.42[医药卫生—临床医学]