Xp11.2易位/TFE3基因融合相关性肾癌的CT与MRI表现  

CT and MRI Findings of Renal Cell Carcinoma Associated with Xp11.2 Translocation/TFE3 Gene Fusions

作　　者：高凯波[1] 赵秀丽 叶慧义[3] 王海屹[3] 常瑞萍[3] 

机构地区：[1]解放军第一六三医院医学影像科,湖南长沙410003 [2]青州市人民医院放射科,山东青州262500 [3]解放军总医院放射诊断科,北京100853

出　　处：《中国医学影像学杂志》2017年第3期222-226,230,共6页Chinese Journal of Medical Imaging

摘　　要：目的探讨Xp11.2易位/TFE3基因融合相关性肾癌(Xp11.2易位性肾癌)的CT与MRI表现。资料与方法回顾性分析经病理证实的18例Xp11.2易位性肾癌患者。10例行CT扫描,其中单纯平扫2例,平扫及增强扫描8例;14例行肾脏MRI平扫及多期多时相扫描,含同时CT平扫2例、CT平扫及增强扫描4例。观察Xp11.2易位性肾癌瘤体的部位、大小、形态、密度/信号特征及血供、强化方式。结果 18例18个病灶均位于皮髓质,实性17个,囊实性1个。病灶最大径平均(4.6±2.0)cm;圆形或类圆形病灶13个,不规则形或分叶状病灶5个。10个病灶CT平扫呈稍高/高密度,平均CT值为(50.6±11.5)HU,4个病灶见钙化;8个病灶CT增强扫描示多血供1个,少血供7个。MRI示14个病灶信号表现多样,均见不同范围稍短/短T1、稍短/短T2信号,增强扫描以髓质期持续强化为主要表现。根据病变主要信号特点及血供情况分3种类型(1个囊实性病灶除外):(1)以短T1短T2信号为主型病灶5个,为少血供;(2)以稍长T1稍T2信号为主型病灶4个,均为多血供;(3)以等T1等T2信号为主型病灶4个,均为相对少血供。结论 Xp11.2易位性肾癌CT、MRI表现有一定的特征,当CT平扫发现位于皮髓质稍高/高密度结节或肿块,MRI表现为信号多样伴有不同范围稍短/短T1、稍短/短T2信号特征,并以髓质期持续强化为特点时,结合临床可提示诊断。Purpose To investigate CT and MRI manifestations of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusions（abbreviation as Xp11.2 translocation renal cell carcinoma）. Materials and Methods Eighteen cases of Xp11.2 translocation renal cell carcinoma confirmed by pathology were retrospectively analyzed. Ten patients underwent CT scans, 2 of them had unenhanced CT and 8 of them had pre-and post-contrast CT scan. Fourteen cases underwent plain and multi-phase contrast MRI scan, including 2 cases with unenhanced CT and 4 cases with pre-and post-contrast CT scan. The location, size, shape, density/signal, blood supply and the enhancement of the Xp11.2 translocation renal cell carcinoma were analyzed. Results All of the 18 tumors located in the corticomedullary with 17 solid lesions and 1 cystic lesion. The mean maximum diameter of the tumor was（4.6±2.0） cm. Thirteen lesions were circular or oval and 5 were irregularly or lobulated lesions. Ten lesions showed slightly high or high density on unenhanced CT, and the average CT value was（50.6±11.5） HU, in which 4 lesions showed calcification. Among 8 cases of enhanced CT, 1 lesion showed abundant blood supply, while 7 lesions showed lack of blood supply. Fourteen cases of MRI scan exhibited various imaging features with short T1 and T2 signal, and the persistent enhancement in the medullary phase. The MRI findings were further divided into 3 types according to the signal intensity and blood supply except 1 cystic lesion：（1） 5 lesions predominantly with short T1 and T2 signal were lack of blood supply;（2） 4 lesions predominantly with slightly longer T1 and T2 signal were abundant blood supply;（3） 4 lesions predominantly with equal T1 and T2 signal were relatively lack of blood supply. Conclusion The CT and MRI features of Xp11.2 translocation renal cell carcinoma had certain manifestations： slightly high or high density nodule or mass located in corticomedullary on pre-contrast CT scan, various signal intensity with short T

关 键 词：肾肿瘤 易位 遗传 体层摄影术 螺旋计算机 磁共振成像 

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