肾上皮样血管平滑肌脂肪瘤CT诊断和误诊原因分析  

The Analysis on CT Diagnosis and Misdiagnosis for Renal Epithelioid Angiomyolipoma

作　　者：游瑞雄[1] 张宇阳[1] 曹代荣[1] 李秀梅[1] 胡建平[1] 

机构地区：[1]福建医科大学附属第一医院影像科,福州350005

出　　处：《临床放射学杂志》2016年第12期1854-1857,共4页Journal of Clinical Radiology

摘　　要：目的分析肾上皮样血管平滑肌脂肪瘤(EAML)的CT影像表现和误诊原因,以期进一步提高EAML的诊断准确率。方法回顾性分析经手术病理证实的13例肾EAML患者CT特征表现,其中11例行CT平扫及增强扫描,2例行CT平扫。结果 CT提示肾癌8例,肉瘤1例,肾血管平滑脂肪瘤4例。所有病例瘤体最大径均>5 cm,均突向肾轮廓外;CT平扫12例病灶密度稍高于肾皮质,7例合并出血,8例合并坏死,4例病灶含脂肪;增强扫描皮质期强化11例,髓质期强化程度减退7例,持续强化4例。2例合并腹膜后淋巴结转移,1例伴有肺肝转移。结论肾EAML的CT表现具有一定特征性,有助于术前定性诊断。Objective To analyze the CT features and the causes for misdiagnosis renal epithelioid angiomyolipoma（ EAML）,and improve its diagnostic accuracy. Methods The CT manifestations of 13 patients with pathologically confirmed renal EAML were retrospectively analyzed. 11 cases had plain and contrast enhanced CT scan performed and 2 cases with plain CT scan only. Results CT indicated renal cancer in 8 cases,sarcoma 1 case and angiomyolipoma in 4 cases.The average diameter of mass was larger than 5cm and the mass was predominantly exophytic. 12 cases showed higher density than normal renal cortex,with intense enhancement in the cortical phase in all 11 cases,declining contrast enhancement in the medullary phase in 7 cases and continuous contrast enhancement in 4 cases. 2 cases had intercurrent retroperitoneal lymphatic metastasis,1 case with liver and lung metastases. Conclusion CT findings of renal EMAL have some specific characteristics and they may be helpful in preoperative diagnosis.

关 键 词：肾 上皮样血管平滑肌脂肪瘤 多层螺旋CT 

分 类 号：R737.11[医药卫生—肿瘤]