肾脏交织状血管瘤的影像学表现:附2例报告并文献复习  

Imaging features of anastomosing hemangioma of the kidney:two cases report and review of the literature

作　　者：李浩杰[1] 梁丽丽[1] 李安琴[1] 胡瑶[1] 胡道予[1] 李震[1] 彭健[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030

出　　处：《现代泌尿生殖肿瘤杂志》2016年第4期201-203,211,共4页Journal of Contemporary Urologic and Reproductive Oncology

基　　金：国家自然科学基金面上项目(81271529)

摘　　要：目的探讨肾脏交织状血管瘤的临床特点及影像学表现,提高对该病的诊断及治疗水平。方法回顾性分析2例原发于肾脏的交织状血管瘤患者的临床资料,2例患者术前接受CT或MRI检查均诊断为肾脏肿瘤性病变,均接受腹腔镜下根治性肾脏切除术。结果肿块在CT上呈类圆形,边界尚清,凸向肾窦,增强呈不均匀性延迟强化特点;T2WI上呈不均匀的稍高信号,DWI呈等或稍高信号,PWI上强化方式与增强CT相似,呈向心性充填。术后病检肿块呈灰褐色,与周围组织境界清,无包膜;显微镜下,肿块具有松散的小叶结构,肿瘤细胞无异型性;免疫组化示CD31(+)、CD34(+)。术后患者恢复良好,未出现明显复发或转移迹象。结论交织状血管瘤是肾脏的良性血管瘤性疾病,临床少见,影像学上有一定的特点,但术前诊断困难。此类病变应与肾脏恶性肿瘤,特别是血管肉瘤相鉴别。治疗上以手术治疗为主。Objective The clinical characteristics and imaging manifestations of renal anastomosing hemangioma were analyzed and evaluated in order to improve its diagnostic accuracy. Methods Clinical data and CT or MRI features of 2cases of pathologic analysis-confirmed renal anastomosing hemangioma were analyzed retrospectively.All cases underwent CT or MR examination and were diagnosed as renal tumors before retroperitoneal laparoscopic nephrectomy. Results One case showed a renal sinus mass with a round,well circumscribed figures,with homogeneously persistent enhancement on contrast-enhanced CT,slightly high signal on DWI and inhomogeneous delayed enhancement characteristics on PWI.The other one showed lightly high signal on T2 WI.Grossly,the resected specimen showed a well circumscribed but un-encapsulated round mass.On cut surface,the tumor was fleshy,brown with a spongy texture abutting but not invasion to the renal capsule.Immunohistochemical analysis revealed that the tumor cells exhibited positivity for CD31,CD34. Conclusions Anastomosing hemangioma was a benign hemangioma of the kidney,and has special imaging characteristics,but the preoperative diagnosis is difficult,and malignant renal tumors should be ruled out,especially angiosarcoma.

关 键 词：交织状血管瘤 肾脏 体层摄影术 X线计算机 磁共振成像 

分 类 号：R737.11[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R730.44