少血供肾脏透明细胞癌的磁共振表现  

Magnetic resonance imaging findings of hypovascular clear cell renal cell carcinoma

作　　者：张洪涛 盛复庚 王海屹[2] 许伟 白旭 叶慧义[2] Zhang Hongtao;Sheng Fugeng;Wang Haiyi;Xu Wei;Bai Xu;Ye Huiyi(Department of Radiology,South Area of the Fifth Medical Center of PLA General Hospital,Beijing 100071,China;Department of Radiology,General Hospital of Chinese People′s Liberation Army,Beijing 100853,China)

机构地区：[1]解放军总医院第五医学中心南院区放射科,北京100071 [2]解放军总医院放射科,北京100853

出　　处：《中华医学杂志》2019年第21期1660-1663,共4页National Medical Journal of China

基　　金：国家自然科学基金面上项目(81471641).

摘　　要：目的分析少血供肾脏透明细胞癌的磁共振成像(MRI)表现。方法回顾性分析2016年2月至2017年3月解放军总医院符合入选标准的少血供肾脏透明细胞癌患者的临床资料和MRI征象。患者共34例,男28例、女6例,年龄35~80岁,平均年龄49.5岁。根据病灶直径分为直径≤4 cm组和直径>4 cm组,并比较两组间的临床资料和MRI影像特征。结果34例患者共34个少血供肾脏透明细胞癌病灶。肿瘤实性成分T2WI呈稍低和等信号31例,呈高信号3例;T1WI呈稍低和等信号29例,高信号5例;扩散加权成像(DWI)10例呈等低信号,24例呈高信号为主。33例肿瘤见假包膜,肿瘤出血12例,坏死9例,囊变22例,含脂质4例。直径≤4 cm组19例,直径>4 cm组15例,其中手术方式和病灶内是否出血在两组间的差异有统计学意义(P<0.05)。结论少血供肾脏透明细胞癌MRI的主要表现为T2WI低信号,DWI高信号,较少出现脂质;直径>4 cm病灶手术更多选择腹腔镜肿瘤根治性切除术,肿瘤更容易出血。Objective To analyze MRI findings of hypovascular clear cell renal cell carcinoma.Methods The clinical data and MRI findings of patients with hypovascular clear cell RCC confirmed by pathology from February 2016 to March 2017 were retrospectively analyzed in General Hospital of Chinese People′s Liberation Army.According to the diameter of the lesions,they were divided into two groups of diameter≤4 cm and group of diameter>4 cm.The data was analyzed by usingχ2 to compare clinical data and tumor imaging characteristics between the two groups.Results Thirty-four patients had 34 hypovascular lesions.The solid part of the tumor showed a slightly hypo-and isointense in 31 lesions,and high signal in 3 lesions;T1WI showed slightly lower and equal signal in 29 lesions and high signal in 5 lesions;DWI showed equal low signal in 10 lesions,24 tumors were mainly high signal;33 lesions showed pseudo-capsule;tumor hemorrhage in 12 lesions,necrosis in 9 lesions and cystic change in 22 lesions,lipid component in 4 lesions.There were 19 lesions with diameter≤4 cm and 15 lesions with diameter>4 cm.The surgical methods and bleeding in the lesion were statistically different between the two groups(P<0.05).Conclusion The MRI findings of hypovascular clear cell RCC are low signal on T2WI,high signal on DWI mainly,less lipid.Laparoscopic radical resection was more suitable for lesions with diameter>4 cm and these lesions were more likely to bleed within the tumor.

关 键 词：磁共振成像 扩散 肾肿瘤 肉瘤 透明细胞 

分 类 号：R737.11[医药卫生—肿瘤]