肾脏混合性上皮间质瘤的CT和MRI表现  

CT and MRI appearances of mixed epithelial and stromal tumor of kidney

作　　者：张丽红[1] 王林省[2] 陈东风[2] 陈月芹[2] 李娴[2] 刘艳杰[2] 李磊[3] ZHANG Lihong;WANG Linsheng;CHEN Dongfeng;CHEN Yueqin;LI Xian;LIU Yanjie;LI Lei(Medical Imaging Center,Jining No.1 People＇s Hospital,Jining 272013,Shandong,China;Department of Medical Imaging,Affiliated Hospital of Jining Medical University,Jining 272029,Shandong,China;Department of Pathology,Affiliated Hospital of Jining Medical University,Jining 272029,Shandong,China)

机构地区：[1]济宁市第一人民医院影像中心,山东济宁272013 [2]济宁医学院附属医院医学影像科,山东济宁272029 [3]济宁医学院附属医院病理科,山东济宁272029

出　　处：《山东大学学报（医学版）》2018年第7期70-75,共6页Journal of Shandong University:Health Sciences

基　　金：济宁市科技项目(2012jnzh04;2013jnwk118)

摘　　要：目的总结肾脏混合性上皮间质瘤(MESTK)的CT和MRI表现,提高对该瘤的诊断正确率。方法回顾性分析经手术病理证实的12例MESTK临床和影像学资料;12例均行CT平扫及增强扫描,其中4例同时行MRI平扫和增强扫描。结果 12例均为单发,右侧4例,左侧8例;椭圆形7例,圆形3例及不规则形2例;肿块直径2.5~6.4 cm,平均4.4 cm。12枚瘤灶均突向肾盂,其边界清楚,其中6例表现为囊实性肿块、5例表现为厚壁囊肿、1例表现为薄壁囊肿;实性部分表现为结节状和团块状,占瘤体比例5%~65%不等,1例瘤内见点状钙化。增强扫描均表现为不同程度延迟强化(轻度强化6例,中度及明显强化各3例)。在T1WI和T2WI+压脂相图像上,4枚肿块内囊性部分分别表现为低信号和高信号,而其实性部分分别表现为稍高信号和略低信号;三期增强扫描均具有不同程度延迟强化特征。邻近肾盂肾盏受压变形,但无破坏。结论 MESTK常表现为边界清楚的囊性或囊实性肿块,瘤内实性部分的形态及含量具有多样性;增强扫描瘤内实性部分呈不同程度延迟强化特征。了解MESTK影像学特征,有助于提高诊断正确率。Objective To summerize CT and MRI appearances of mixed epithelial and stromal tumor of kidney（ MESTK）,and to improve the diagnostic accuracy. Methods The clinical and imaging materials of 12 MESTK patients confirmed by pathology were analyzed retrospectively. The patients underwent unenhanced and enhanced CT scan,and four of them underwnt unenhanced and enhanced MRI scan at the same time. Results Twelve cases were all singular,with four located in the right side and eight in the left side; seven leisions were oval,three were round and two were irregular.The diameters of all lesions ranged from 2.5 to 6.4 cm,with a mean value of 4.4 cm. The tumors had well-defined margin and projected to the pelvis on unenhanced CT scan,with six presented solid cystic,5 thick-wall cystic masses,and 1 thin-wall cystic masses. The solid portions in the masses depicted nodular and mass-like,accounting for5%-65%,and calcification was found in one case. The tumors presented variably prolonged enhancement on enhanced triple-phased CT scan,with six cases being slightly enhanced,three being markedly enhanced and moderately enhanced.On unenhanced T1 WI and fat-suppressed T2 WI images,four cystic portions appeared hypointesity and hyperintensity,while the solid portions presented slightly hyperintensity and hypointesity,respectively. The tumors also demonstrated variably prolonged enhancement on enhanced T1 WI images. Adjacent renal pelvis and calices were compressed,but withoutdestruction. Conclusion MESTK usually depicts well-defined cystic or solid-cystic mass projecting to renal pelvis,and the amount and shape of its solid portions present diversity. The solid components is variably prolonged enhancement on multiple-phased enhanced CT and MRI. Comprehension the iconography features of MESTK is helpful to improve the diagnostic accuracy.

关 键 词：肾脏 混合性上皮间质瘤 磁共振成像 体层摄影术 X线计算机 

分 类 号：R814.4[医药卫生—影像医学与核医学] R816.7[医药卫生—放射医学]