不典型肾血管平滑肌脂肪瘤的影像学诊断  

Imaging diagnosis of atypical renal angiomyolipoma

作　　者：刘翔[1] 俞咏梅[1] 窦彤[1] 崔艳秋[1] 

机构地区：[1]皖南医学院第一附属医院弋矶山医院影像中心,安徽芜湖241001

出　　处：《皖南医学院学报》2016年第1期75-78,共4页Journal of Wannan Medical College

摘　　要：目的:探讨不典型肾血管平滑肌脂肪瘤的影像学表现,以提高其诊断水平。方法:回顾性分析17例经手术、病理证实的不典型肾血管平滑肌脂肪瘤影像资料,研究其CT和MRI影像特征。结果:17例不典型肾血管平滑肌脂肪瘤中CT呈稍高密度者9例、等密度者4例、低密度者4例;MRI fs T2WI呈低信号者11例、稍高信号者6例,CT密度/MR信号均匀者6例;含有脂质者5例;出血者6例;囊变坏死者6例;CT显示黑星征5例;病灶与肾实质交界面平直、尖端成角者13例;均匀强化者7例、非延迟强化者15例。最大径≤4 cm者10例,>4 cm者7例。两组之间出现出血、囊变坏死征象差异有统计学意义(P<0.05)。结论:不典型RAML影像特征主要有CT平扫病灶可呈等、高、低密度,MRI fs T2WI多呈低信号,钙化罕见,病灶与肾实质交界面多平直,增强后可均匀强化,可有黑星征。Objective： To understand the imaging properties of atypical renal angiomyolipoma for accurate diagnosis of this condition. Methods： The imaging data,including the CT and MRI manifestation,were reviewed in 17 cases of renal angiomyolipoma confirmed by postoperative pathology. Results：Slightly high density was shown on CT in 9 cases,isodensity in 4 and low density in 4. MRI scanning by fs T2 WI demonstrated that 11 cases were low intensity signal and 6,slightly high intensity. Homogeneous density / signal intensity occurred on both CT and MRI in 6 cases. Visible dots of adipose tissue was seen in 5 cases,hemorrhage in 6 and cystic necrosis in 6.＂Black star＂sign occurred on CT in 5 cases,and angular interface with renal parenchyma was seen in 13 cases,homogeneous enhancement in 7 and free delayed enhancement in 15. The maximum diameter of mass was ≤4 cm in 10 cases,and 4 cm in 7. The two groups were significant regarding the hemorrhage and cystic necrosis（ P〈0. 05）. Conclusion： Atypical renal angiomyolipoma commonly demonstrates featured signals of isodensity,high or low density on plain CT scans,and primarily low intensity signal on MRI by fs T2 WI. Calcification rarely occurs,yet angular interface with renal parenchyma,homogeneously contrasted enhancement and＂black star＂sign are common.

关 键 词：肾脏 血管平滑肌脂肪瘤 体层摄影术 X线计算机 

分 类 号：R737.11[医药卫生—肿瘤] R445[医药卫生—临床医学]