≤4cm肾少脂肪血管平滑肌脂肪瘤与透明细胞癌的CT鉴别诊断  

The CT Differential Diagnosis of Small Kidney Angioleiomyolipoma Containning Minimal Fat and Clear Cell Renal Cell Carcinoma

作　　者：张莹莹[1] 罗实[2] 徐荣天[3] 

机构地区：[1]辽宁省肿瘤医院放射科,沈阳110042 [2]沈阳市第四人民医院放射科,110031 [3]中国医科大学附属第一医院放射科,沈阳110001

出　　处：《临床放射学杂志》2014年第3期406-409,共4页Journal of Clinical Radiology

基　　金：辽宁省教育厅科研项目计划(编号:L2010665)

摘　　要：目的回顾性分析直径≤4 cm的肾少脂肪血管平滑肌脂肪瘤(AML)与透明细胞癌(CCRCC)的CT表现,以期提高二者的影像诊断水平。方法回顾性分析经手术病理证实的15例少脂肪AML及45例CCRCC的CT扫描图像,包括多种CT征象、病灶各期密度值及增强程度值,对相应资料进行统计学分析。结果少脂肪AML与CCRCC在性别、平扫密度、强化均匀性及病灶中心定位上差异有统计学意义(P<0.05)。两组病例在年龄、瘤内坏死或囊变、肿瘤直径、形状、钙化、边界、皮质掀起征、强化类型及病灶与正常肾实质交角上差异无统计学意义(P>0.05)。少脂肪AML病灶平扫密度高于CCRCC(P<0.05);皮质延髓期及早期排泄期肿瘤密度值无明显差异(P>0.05),但CCRCC肿瘤增强程度值均高于少脂肪AML(P<0.05)。结论平扫密度、增强均匀性、病灶中心定位及肿瘤增强程度值对二者鉴别诊断起重要作用。Objective To analyze the CT performances of kidney angioleiomyolipoma containing minimal fat and clear cell renal cell carcinoma（ in diameter of≤4 cm ）. Methods The CT images of 15 patients with AML eontainning minimal fat and 45 patients with CCRCC confirmed by pathology were retrospectively analyzed. The CT features of AML containning minimal fat and CCRCC on plain and muhiple phase enhancement were compared. Results The features, included sex, unenhaneement, non homogenous enhancement and location of lesion center had significant differences between AML containning minimal fat and CCRCC （ P 〈 0.05 ）. The age of patient, tumor necrosis or cystic degeneration, the tumor diameter, shape, calcification, boundary, cortex set off sign, enhancement type, and angle of intersection had no significance difference between AML eontainning minimal fat and CCRCC （ P 〉 0.05 ）. The CT attenuation of AML containing minimal fat was higher than that of CCRCC on plain CT images （ P 〈 0.05 ）. The tumor density value of cortieobulbar period and early discharge period bad no significance differences between AML containing minimal fat and CCRCC （ P 〉 0.05 ） , but the enhanced degree of CCRCC were higher than that of AML containning minimal fat （ P 〈 0.05 ）. Conclusion Unenhanement, non homogenous enhanement, location of the lesion center and tumor enhancement degree play an important role in differential diagnosis of AML containning minimal fat and CCRCC.

关 键 词：肾肿瘤 体层摄影术 X线计算机 对比分析 

分 类 号：R737.11[医药卫生—肿瘤] R730.44[医药卫生—临床医学]