肾平滑肌瘤的MRI表现  

MR imaging appearance of renal leiomyoma

作　　者：许伟 白旭 常瑞萍[1] 袁静[2] 黄庆波[3] 王海屹[1] 叶慧义[1] XU Wei;BAI-Xu;CHANG Rui-ping;YUAN Jing;HUANG Qingbo;WANG Haiyi;YE Huiyi(Department of Radiology,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院放射诊断科,北京100853 [2]中国人民解放军总医院病理科,北京100853 [3]中国人民解放军总医院泌尿外科,北京100853

出　　处：《放射学实践》2018年第8期816-819,共4页Radiologic Practice

基　　金：国家自然科学基金(81471641)

摘　　要：目的:分析肾平滑肌瘤的MRI表现,提高影像诊断准确性。方法:回顾性分析2006-2018年经本院病理证实的9例肾平滑肌瘤的MRI表现,重点分析病变的形态、有无假包膜、脂质、出血和囊变坏死、在T2WI、T1WI和DWI上的信号特点及动态增强扫描表现。结果:9例肾平滑肌瘤长径为10~84mm,平均40.3mm。所有病变(9/9)在T1WI上呈等或稍低信号,未见脂质和出血信号,出现囊变坏死3例(3/9);在T2WI上呈类圆形等或稍低信号8例(8/9),其中有假包膜5例(5/9);在DWI上呈等及稍高信号8例(8/9);在皮髓质期呈不均匀轻度强化7例(7/9),病灶实性部分表现为延迟期均匀强化9例(9/9)。结论:肾平滑肌瘤的MRI表现有一定特征性,DWI和动态增强扫描可提高诊断准确性。Objective:To analyze the MRI features of renal leiomyoma and to improve the diagnostic accuracy.Methods:The MRI findings of 9 cases with pathologically proved renal leiomyoma from January 2006 to January 2018 were reviewed retrospectively.The MRI features of the lesions were analyzed with emphasis on pseudocapsule,lipid,hemorrhage,cystic degeneration and necrosis,and signal intensity features on T 2WI,T 1WI,DWI and contrast enhanced images.Results:In the nine cases,the maximum diameter of lesions was 10~84mm,with average length of 40.3mm.On T 1WI,all lesions(9/9)showed iso-or slightly hypo-intensity,and no signs of lipid and hemorrhage were found in them,3 lesions(3/9)showed cystic degeneration and necrosis.On T 2WI,8 lesions(8/9)were round-shaped and showed iso-or slight hypo-intensity,and 5 cases(5/9)demonstrated pseudocapsules.8 lesions(8/9)showed iso-or slightly hyper-intensity on DWI.After contrast media injection,7 lesions(7/9)demonstrated mild heterogeneous enhancement in the cortico-medullary phase,and the solid areas of all lesions showed progressive homogeneous enhancement in the delayed phase.Conclusion:Renal leiomyomas has some characteristic features on MR DWI and dynamic contrast enhanced images are helpful to diagnostic accuracy.

关 键 词：肾肿瘤 平滑肌瘤 磁共振成像 诊断 

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]