乏脂肪肾血管平滑肌脂肪瘤的MSCT和MR化学位移成像表现及病理基础  

MSCT and MR on Chemical Shift Imaging Features of Minimal Fat Renal Angiomyolipoma Correlated with Pathology

作　　者：黄海东[1] 刘洪[1] 曹伟[1] 高立勇[1] 赵蕤[1] 贺广珍[1] 

机构地区：[1]徐州市第一人民医院影像科,江苏徐州221002

出　　处：《CT理论与应用研究（中英文）》2015年第3期467-474,共8页Computerized Tomography Theory and Applications

摘　　要：目的:探讨乏脂肪肾血管平滑肌脂肪瘤(AML)的多排螺旋CT(MSCT)和MR化学位移成像(CSI)表现及病理基础,旨在提高对该病诊断的准确率。方法:回顾性分析经病理证实的16例乏脂肪肾AML患者的MSCT和MRI资料,分析病灶的大小、形态、密度、增强血供情况及CSI表现,并与手术病理结果对照。结果 16例病灶均表现为实质性肿块,10例病灶呈类圆形,6例病灶呈不规则形,9例病灶见劈裂征,6例见杯口征,5例见皮质掀起征,11例病灶CT平扫呈稍高密度,其中4例密度不均匀,内见小灶性低密度。增强扫描病灶呈快进快退、持续强化和延迟强化三种模式,但峰值强化程度均低于肾皮质。MR成像T2WI病灶均呈低信号,CSI中3例出现反相位信号下降,其中1例呈现反相位病灶中心高信号,周围绕以线状低信号环的特殊表现。结论:乏脂肪肾AML的MSCT和MRI表现有一定特征性,薄层MR反相位CSI对该病诊断有较高的价值。Objective： To explore the Multi-slice CT（MSCT） and chemical shift imaging（CSI） manifestations of minimal fat renal angiomyolipoma（RAML） with pathology results and to improve its accuracy of diagnosis. Methods： The data of 16 cases of RAML patients were retrospectively analyzed in comparison with pathological results, including tumor size, shape, density, enhancement degree and patterns, CSI imaging features. Results： 16 lesions were all solid tumor masses. 10 lesions showed round, 6 lesions irregular in shape. moreover, split sign appearance was found in 9 lesions, cup sign in 6 lesions and cortical up sign in 5 lesions. On precontrast CT, 11 cases showed hyperattenuation, including 4 heterogeneous lesions with focal low density. Three pattern were demonstrated by enhanced scanning including wash-in and wash-out, continuous enhancement and delayed enhancement. but peak enhancement degree was lower than the renal cortex. Furthermore, 5 lesions showed hyperintensity on T2-weighted MRI. Hypointensity on out-phase CSI were seen in 3 lesions. Among them, one case showed high signal center surrounded by linear low signal ring. Conclusion： MSCT and MRI examination of minimal fat RAML demonstrates certain characteristic signs, thin layer out-phase CSI may be helpful for diagnosis of the disease.

关 键 词：肾肿瘤 血管平滑肌脂肪瘤 计算机体层成像 化学位移 病理学 

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