肾嗜酸细胞腺瘤的MRI征象  

MRI features of renal oncocytoma

作　　者：勾振恒 王海屹[2] 闫非 郭爱桃[3] 马鑫[2] 马露[2] 钟燕[2] 陈鑫[3] 叶慧义[2] Gou Zhenheng, Wang Haiyi, Yan Fei, Guo Aitao, Ma Xin, Ma Lu, Zhong Yan, Chen Xin, Ye Huiyi.(Department of Radiology, Daxing Teaching Hospital, Capital Medical University, Beijing 102600, Chin)

机构地区：[1]首都医科大学大兴教学医院放射科,北京102600 [2]解放军总医院放射科 [3]解放军总医院病理科

出　　处：《中华放射学杂志》2018年第4期286-290,共5页Chinese Journal of Radiology

基　　金：国家自然科学基金面上项目（81471641）

摘　　要：目的探讨肾嗜酸细胞腺瘤（RO）的MRI特征。方法回顾性分析2006年9月至2017年5月解放军总医院经手术病理证实为RO，且术前进行肾脏MRI平扫及动态增强扫描的26例患者的资料，根据病灶直径将RO分为直径≥3 cm组（16例，共16个病灶）和直径〈3 cm组（10例，共11个病灶）。观察每个病灶的特征，包括部位、假包膜、脂质等11项指标。比较两组间肿瘤影像特征，进行单因素和多因素logistic回归分析。结果27个RO病灶，12个位于左肾，15个位于右肾，25个（92.6%，25/27）表现为外生形态，10个（37.0%，10/27）出现外生锥形交界面，25个（92.6%，25/27）出现假包膜，4个（14.8%，4/27）出现脂质，2个（7.4%，2/27）出现囊变坏死，1个（3.7%，1/27）出现出血，13个（48.1%，13/27）出现纤维瘢痕，19个（70.4%，19/27）表现为皮质期中度以上强化，9个（33.3%，9/27）出现辐轮状强化，2个（7.4%，2/27）出现节段性强化反转。单因素logistic回归分析示外生性锥形交界面、纤维瘢痕、皮质期中度以上强化、辐轮状强化在直径≥3 cm组和〈3 cm组RO病灶中比较优势比分别为0.054、9.898、8.400、10.000。多因素logistic回归分析提示纤维瘢痕、辐轮状强化剔出模型，选入回归模型的变量为外生性锥形交界面、皮质期中度以上强化，在直径≥3 cm组和〈3 cm组RO病灶中出现率有差别，优势比分别为0.033、15.381。结论MRI上RO主要表现是双肾均可发生，多外生形态，具有假包膜，较少出现脂质、囊变坏死及出血及节段性强化反转；较小的病灶（直径〈3 cm）容易出现外生性锥形交界面，较大的病灶（直径≥3 cm）可以有纤维瘢痕、辐轮状强化、皮质期中度及明显强化的特点。Objective To investigate the MRI features of renal oncocytoma （RO）.MethodsWe retrospectively analyzed the data of 26 patients by histologically confirmed with RO in Chinese PLA General Hospital from September 2006 to May 2017 and performed pre-operative MRI and dynamic contrast-enhanced MRI. Lesions were divided into two groups based on the diameter： large group with large than 3 cm （16 cases, 16 lesions） and small group with less than 3 cm （10 cases, 11 lesions）. Features of each lesion were analyzed, including location, pseudocapsules, lipids and other 11 indicators. Tumor imaging features were compared between two groups by univariate and multivariate logistic regression analysis. Results Of 27 RO lesions, 12 were located in the left kidney and 15 in the right kidney. Twenty five lesions appeared exophytic （92.6%, 25/27）, 10 lesions showed exophytic angular interface （37.0%, 10/27）, 25 lesions showed pseudocapsule （92.6%, 25/27）, 4 lesions appeared lipid （14.8%, 4/27）, 2 lesions showed cystic degeneration or necrosis （7.4%, 2/27）, 1 lesion showed hemorrhage （3.7%, 1/27）, 13 lesions appeared fibrous scar （48.1%, 13/27）, 19 lesions with moderate or intense enhancement in the corticomedullary phase （70.4%, 19/27）, 9 lesions with wheel-spoke-like enhancement （33.3%, 9/27）, and 2 lesions showed segmental enhancement inversion （7.4%, 2/27）. Univariate logistic regression exhibited statistically significant correlation between exophytic angular interface with renal parenchyma, fibrous scar, moderate or intense enhancement in the corticomedullary phase, and wheel-spoke-like enhancement of the tumors both in small and large RO groups with OR value of 0.054, 9.898, 8.400 and 10.000, respectively. In the multivariate logistic regression analysis, exophytic angular interface with renal parenchyma and intense enhancement in the corticomedullary phase were found to be high risk factors with OR value of 0.033 and 15.381, respectively.ConclusionsThe main manifestation of

关 键 词：肾肿瘤 嗜酸细胞腺瘤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.11[医药卫生—诊断学]