肾血管瘤CT和MRI特征分析  

Computed tomography and magnetic resonance imaging findings of hemangioma in renal

作　　者：钟莲婷 丁玉芹 王睿婷 唐启瑛 吴丽兰 姜秋利 周建军 ZHONG Lian-ting;DING Yu-qin;WANG Rui-ting;TANG Qi-ying;WU Li-lan;JIANG Qiu-li;ZHOU Jian-jun(Department of Radiology,Zhongshan Hospital(Xiamen Branch),Fudan University,Xiamen 361015,Fujian,China;Department of Radiology,Zhongshan Hospital,Fudan University/Shanghai Institute of Medical Imaging,Shanghai 200032,China;Department of Cancer Center,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Pathology,Zhongshan Hospital(Xiamen Branch),Fudan University,Xiamen 361015,Fujian,China)

机构地区：[1]复旦大学附属中山医院厦门医院放射科,厦门361015 [2]复旦大学附属中山医院放射科,上海市影像医学研究所,上海200032 [3]复旦大学附属中山医院肿瘤防治中心,上海200032 [4]复旦大学附属中山医院厦门医院病理科,厦门361015

出　　处：《中国临床医学》2022年第5期772-778,共7页Chinese Journal of Clinical Medicine

基　　金：福建省卫生健康科研人才培养项目医学创新课题(2019CXB33);福建省科技计划项目引导性项目(2019D025)。

摘　　要：目的探讨肾血管瘤的CT和MRI特征,为其诊断进一步提供参考。方法回顾性分析经手术病理证实的10例肾血管瘤患者的临床特征及影像表现,其中3例行CT、5例行MRI、2例同时行CT和MRI检查,总结其影像特征。结果10例肾血管瘤中,7例为吻合状血管瘤,6例位于肾髓质、3例位于肾窦、1例位于肾实质,肿瘤最大径1.4~6.4 cm,8个病灶表现为类圆形。所有病灶均以实性为主,3例有包膜。4例T_(2)WI呈明显高信号,6例DWI呈高信号;在ADC图上3例呈等信号,2例呈高信号,2例呈低信号;8例表现为皮髓质期瘤周明显结节、斑片状强化,后期逐渐向中心填充,1例明显不均匀强化,1例不强化。CT多期增强扫描中,肾血管瘤实质期强化率高于腹主动脉(P<0.05),皮髓质期强化率与腹主动脉差异无统计学意义;肾血管瘤在MRI增强扫描皮髓质期及肾实质期的强化率与肾皮质及腹主动脉差异无统计学意义。结论肾血管瘤好发于肾髓质或肾窦部,多为吻合状血管瘤;影像表现具有一定的特征性:T_(2)WI多呈明显高信号,动态增强扫描中皮髓质期病灶周边明显结节样强化,逐渐向中心填充,强化程度与腹主动脉或肾皮质相仿。Objective To explore the CT and MRI characteristics of renal hemangioma and to improve the diagnostic efficacy for such tumors.Methods The clinical data of 10 patients with renal hemangioma approved by pathological were respectively analyzed.3 patients underwent CT scanning,5 patients underwent MRI,and 2 patients underwent both CT and MRI.The imaging characteristics of renal hemangioma were summarized.Results There were 7 patients with anastomosing hemangioma.6 lesions were located in the renal medullary and 3 in the renal sinus,1 in the parenchyma.Maximum diameter ranged from 1.4 to 6.4 cm.8 lesions showed round shape.All lesions were shown as mainly solid,and 3 owned capsule.Of the 7 lesions performed MRI,4 showed obvious high signal intensity on T_(2)WI stage,6 showed high signal intensity on DWI image;3 showed equal signal intensity on ADC image and high and low signal intensity all performed in 2 lesions.8 patients showed obvious nodular or patchy enhancement around the tumor in the corticomedullary phase(CMP),and with the character of“filled in”in the later stage.The enhancement rate of renal hemangioma in the nephrographic phase(NP)was higher than the abdominal aorta on CT(P<0.05),but there was no difference on CMP.The enhancement rate of the renal hemangioma was no difference with renal cortex and abdominal aorta on MRI.Conclusions Renal hemangiomas more perform anastomosing hemangioma and mostly local on medullary or sinus.With characteristics of high signal intensity on the T_(2)WI stage,nodular enhancement around the lesion in the CMP and progressive centripetal filling are performed over time and the enhancement intensity is similar to the abdominal aorta or renal parenchyma.

关 键 词：肾肿瘤 血管瘤 体层摄影技术 磁共振成像 

分 类 号：R737.11[医药卫生—肿瘤]