肾脏嫌色细胞癌的影像征象与病理对照分析  

Imaging features and clinicopathological manifestations of chromophobe cell renal carcinoma

作　　者：郭媛[1] 徐凡[1] 刘国顺[1] 吴红珍[1] 莫蕾[1] 吴梅[1] 

机构地区：[1]广州市第一人民医院放射科,广东广州510180

出　　处：《实用放射学杂志》2015年第1期98-101,105,共5页Journal of Practical Radiology

摘　　要：目的：分析肾脏嫌色细胞癌（CCRC）的 CT、MRI 影像征象以及与病理组织学的关系。方法回顾性分析23例经手术病理证实的 CCRC 的 CT、MRI 影像资料,分别观察肿瘤的部位、形状、大小、密度、边界、血供以及对周围脏器的侵犯等,重点分析其动态增强方式,并与病理对照。结果23例患者均为一侧肾脏单发肿块,其中左肾12例,右肾11例,病灶直径27~330 mm,圆形或类圆形,16例边界清晰,7例边界欠清。肿瘤突破肾包膜3例,侵及肾盂、肾周脂肪伴肾静脉、下腔静脉癌栓3例,腹膜后淋巴结转移2例。18例患者行 CT 检查,平扫病灶呈软组织密度（CT 值为30～44 HU）,6例患者行 MRI 扫描,T1 WI 呈等/稍低信号, T2 WI 信号不均,呈高低混杂信号,2例假包膜表现为 T2 WI 环形低信号影。根据动态增强方式不同,分为3型。（1）轻中度强化型（14例）：包括轻度均匀强化（7例）与轻度不均匀强化（7例）；（2）明显强化型（7例）：6例为不均匀强化；1例为均匀强化；（3）轮辐状或瘢痕样强化（2例）。CCRC 大体标本以实性成分为主,切面呈黄棕色或褐色,镜下根据 HE 染色情况分为3型：经典型、嗜酸细胞型、混合型。结论肾 CCRC 的动态增强表现有一定特征性,综合分析其影像学表现,有助于诊断及鉴别诊断。Objective To investigate the imaging features and the relationship with pathological characteristics of chromophobe cell renal carcinoma （CCRC）.Methods The clinicopatholocal manifestations and CT or MRI imaging findings were analyzed retro-spectively in 23 patients with surgically confirmed CCRC.The location,shape,size,density,border,blood supply and invasion of adjacent organs of CRCC,especially the dynamic enhanced mode,were mainly analyzed and compared with pathology.Results The 23 cases of CCRC showed unilateral single mass on CT and MRI scans,and 12 located in right kidney while 1 1 in left kidney.The size ranged from 27-330 mm in diameter,and round or oval-shaped soft tissue mass was observed.The boundaries of 1 6 cases were clear,and 3 cases of mass broke through renal capsule,3 invaded renal pelvis,perirenal fat,renal vein and inferior vena cava,2 ca-ses with retroperitoneal lymph node metastases.18 cases were scanned by CT and the mass presented as soft tissue density on plain CT （CT value 30-44 HU）.6 cases were scanned by MRI with abnormalities presenting with iso or hypo-intense on the T1 WI,hy-per or hypo-intense on the T2 WI,and 2 cases of pseudocapsule were showed as circled hypointense on T2 WI.According to the dy-namic enhancement,23 cases of CCRC were divided into three type：（1 ）Mild-to-moderate enhanced type（n= 14）：including mild homogeneous strengthening （n=7）and mild heterogeneous strengthening （n=7）;（2）Significantly enhanced type（n=7）：including heterogeneous enhancement（n=6）and uniform enhancement（n=1）;（3）Spokes shape or scar enhancement（n=2）.The sample of CCRC was mainly solid and showed yellowish-brown or brown section.According to the situation of HE staining,the characteristic microscopic features were divided into three types：the typical,acidophil type and mixed type.Conclusion Combined imaging find-ings of CT dynamic enhanced mode can provide characteristic information for diagnosis of CCRC,and comprehensive analysis of the imaging

关 键 词：肾脏 嫌色细胞癌 计算机体层成像 动态增强 病理学 

分 类 号：R737.11[医药卫生—肿瘤] R814.42[医药卫生—临床医学]