≤3cm肾外型透明细胞癌与乏脂肪血管平滑肌脂肪瘤的CT鉴别  

The CT differential diagnosis of ≤3 cm renal clear cell carcinoma and renal angiomyolipoma with minimal fat

作　　者：王波[1] 董芳宏[1] 厉位明[1] 叶芮英 

机构地区：[1]浙江中医药大学附属金华市中医医院放射科,浙江金华321017

出　　处：《实用放射学杂志》2016年第4期573-575,583,共4页Journal of Practical Radiology

摘　　要：目的 探讨长径≤3 cm且病灶中心位于肾轮廓外的肾透明细胞癌（CCRCC）与乏脂肪血管平滑肌脂肪瘤（AML）的CT特征，比较两者的影像学异同点。方法 回顾性分析经手术病理证实的6例CCRCC和18例乏脂肪AML，对其CT形态学特征、CT平扫及增强CT值进行差异性分析。结果 2组病灶的长径、形态、早期排泄期CT值及早期排泄期强化幅度差异无统计学意义（P＞0.05）。病灶内囊变坏死差异有统计学意义（P＜0.05）。病灶的平扫密度、强化均匀性、假包膜征象及平扫CT值、皮髓质交界期CT值、皮髓质交界期强化幅度差异有显著统计学意义（P＜0.001）。结论 病灶内囊变坏死、平扫密度、强化均匀性、假包膜征象、平扫CT值、皮髓质交界期CT值及强化幅度对CCRCC与乏脂肪AML的鉴别诊断起重要作用。Objective To study the differences between renal clear cell renal cell carcinoma （CCRCC） and angiomyolipoma （AML） with minimal fat, whose size were both smaller than 3cm and the lesions center were both located outside the renal contour. Methods 6 cases of CCRCC and 18 cases of AML with minimal fat were analyzed retrospectively. All the lesions were confirmed pathologically. The morphological characteristics, plain and enhanced CT values were obtained for compare. Results The lesion length diameter, morphology, the early excretory phase CT value and the pattern of enhancement were not significant different between the two groups （P〉0. 05）. There was significant difference in the focal cystic and necrotic between CCRCC group and AML group （P〈0.05）. Plain scan density, enhanced uniformity, pseudo capsule sign, plain CT values, medullary junction CT value and the pattern of enhancement from medullary junction phase were statistically different between those two groups （P〈 0. 001 ）. Conclusion The focal cystic and necrotic,plain scan density, enhanced uniformity,pseudo capsule signs,plain CT values,the cortex and medullary junction CT value and the enhanced amplitude were very important role in differential diagnosis of CCRCC and AML with minimal fat.

关 键 词：肾肿瘤 肾透明细胞癌 肾血管平滑肌脂肪瘤 计算机体层成像 

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