肾脏孤立性纤维性肿瘤MSCT表现分析  

MSCT Imaging Manifestations of Benign and Malignant Solitary Fibrous Tumor of The Kidney

作　　者：孙毅[1] 刘静芳[1] 孙志先[1] 张苏波[1] 杨波[1] 杨杰[1] 

机构地区：[1]江苏省连云港市第二人民医院影像科,222023

出　　处：《临床放射学杂志》2016年第4期593-596,共4页Journal of Clinical Radiology

摘　　要：目的分析肾脏孤立性纤维性肿瘤（SFT）的MSCT表现及病理学特征,提高对本病影像学表现的认识。方法搜集经病理证实的7例肾脏SFT的MSCT影像资料,分析病变良恶性、部位、数量、大小、形态、边缘、密度、强化程度和方式、供血血管等。结果 CT诊断良性6例,恶性1例,与病理符合率100%。7例均为局灶型,最大直径2.8~11.2 cm,4例位于左肾,3例位于右肾。良性肿瘤呈类圆形及不规则形各3例,其中1例肿瘤伴有钙化及坏死,余呈稍高均匀密度软组织肿块,边界清楚,呈膨胀性生长;恶性病变呈类圆形囊实性肿块,密度不均,实质部分稍高于肾实质,边界不清,呈浸润性生长。CT增强皮质期肿瘤实质呈轻中度斑片状不均匀强化,实质期强化更明显,呈进行性强化方式。后处理显示肾动脉分支参与供血。病理示肿瘤由梭形细胞、纤维及血管组成。结论肾脏原发性SFT罕见,CT表现具有一定特征性且与临床病理密切相关,CT可以用于鉴别其良恶性。Objective To study CT imaging manifestations and pathological features of benign and malignant solitary fibrous tumor（ SFT） of the kidney,and to highlight the awareness of this disease. Methods CT findings of 7 patients with SFT proved by pathology were retrospectively reviewed. The benignity / malignancy,size,margin,location,blood supplies and density characteristics on non-enhanced and enhanced scans were analyzed. Results Among the CT diagnoses,6 cases were benign tumors and 1 case was a malignant tumor,with the diagnosis accordance rate of 100%. All cases were focal type. The dimensions ranged from 2. 8cm to 11. 2cm. 4 cases were located in the left kidney and 3 cases in right. Benign tumors had homogenous density,clear margins and showed expansive growth pattern. Of the benign tumours,3 cases were oval in shape; 3 cases were irregular in shape and 1 case had calcification and necrosis. The malignant case showed a mixed solid-cystic mass,heterogenous density,obscure margins and an infiltrative growth pattern. On enhanced scans： the tumors showed intermediate heterogeneous enhancement in arterial phase and progressive enhancement in nephrogenic phase. The renal artery could be shown to supply blood to the tumor by image post-processing techniques. The tumor tissues mainly consisted of spindle cells with rich fibers and vessels. Conclusion CT manifestations of SFT in the kidney have some characteristics which are closely correlated with the clinical pathological findings; CT can be used in differentiating benign from malignant SFT of the kidney.

关 键 词：肾肿瘤 孤立性纤维瘤 体层摄影术 X线计算机 

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