浸润性肾盂癌 MRI 诊断价值  

Diagnostic value of MRI in infiltrative renal pelvis carcinoma

作　　者：李浩杰[1] 梁丽丽[1] 李安琴[1] 胡瑶[1] 胡道予[1] 李震[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,湖北武汉430030

出　　处：《实用放射学杂志》2017年第2期236-239,共4页Journal of Practical Radiology

基　　金：国家自然科学基金面上项目（81271529）.

摘　　要：目的：分析并评价浸润性肾盂癌的 MRI 影像学特征,以提高对其诊断与鉴别诊断的能力。方法回顾性分析病理证实为浸润性肾盂癌的21例患者资料,所有患者均接受 MRI 平扫及 DWI 检查,其中3例进行 PWI 检查。结果21例浸润性肾盂癌中心均位于肾脏集合系统,肾脏轮廓大多无明显变化。病灶在 MRI 平扫上大多呈稍长 T1稍短 T2信号,5例病灶呈混杂 T1混杂 T2信号,病灶在 DWI 均呈高信号。3例行 PWI 扫描呈轻-中度强化。3例行肾 AMRA 检查显示肾动脉受包绕推挤,4例伴有静脉癌栓形成,11例伴有腹膜后淋巴结转移,3例伴有肾上腺转移。1例伴有输尿管尿路上皮癌,2例伴有膀胱癌。结论MRI 具有多参数成像能力及较高的软组织分辨率,可清晰显示病灶部位及周围关系,对浸润性肾盂癌诊断及鉴别诊断具有较高的价值。Objective MRI manifestations of infiltrative renal pelvis carcinoma were analyzed and evaluated,to improve its diagnostic accuracy. Methods MRI features of 21 cases of infiltrative renal pelvis carcinoma confirmed pathologically were analyzed retrospectively.All patients underwent plain MRI scan and DWI examination,3 cases underwent PWI examination.Results The center of lesions for all cases were located in the renal collection system,with no change of the renal contour.Most lesions were presented as low signal intensity on T1 WI and slightly low signal intensity on T2 WI,and heterogeneous signal intensity were showed on T1 WI and T2 WI in 5 cases.All lesions were presented as high signal intensity on DWI.After contrast enhancement,mild and moderate enhanced lesions were demonstrated in 3 cases.Renal arteries were wrapped by renal pelvis carcinoma on renal AMRA in 3 cases.4 patients were accompanied with venous tumor thrombus and 1 1 patients with retroperitoneal lymph node metastasis.Adrenal gland metastases were showed in 3 cases.1 case was accompanied with ureter urothelial carcinoma,and 2 cases with bladder carcinomas.Conclusion MRI has a multi-parameter imaging capability and high resolution of soft tissue,and can clearly show the boundary of lesions and surroundings.MRI plays an important role in the diagnosis and differential diagnosis of infiltrative renal pelvis carcinoma.

关 键 词：肾盂癌 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]