肾错构瘤的CT及MRI影像学表现特点分析

摘要

目的：探讨不典型肾错构瘤的CT及MRI影像学表现特点，为临床术前诊断准确性提供依据。方法对比经病理确诊34例肾错构瘤患者的临床病理及影像学资料，同时选择同期入院治疗的26例肾透明细胞癌患者进行比较；均分别采用CT、MRI扫描检查。结果1）少脂肪肾错构瘤（34例）：CT扫描显示6例呈等密度、4例呈混杂低密度、24例呈稍高密度；10例MRI平扫：其中T2均表现均匀低信号、T1呈等信号；增强扫描：34例患者均表现均匀强化，皮质期中度强化者20例、明显强化8例、6例为一过性强化；2）肾透明细胞癌（26例）：CT平扫：13例表现低密度、7例为等密度、6例为混杂低密度；呈类圆形或圆形，直径平均为（2．9±0．7） cm；7例MRI平扫：T2均表现混杂稍高信号、T1为等低信号，2例存假包膜；增强扫描：15例患者皮质期不均匀强化、7例呈中度强化且实质期、肾盂期强化征象明显减退。结论 CT检查少脂肪肾错构瘤具有一定特性，联合MRI扫描检查可提高对少脂肪肾错构瘤与肾透明细胞癌的鉴定。%Objective To explore the imaging features of CT and MRI of atypical renal hamartoma , so as to provide the basis for accurate diagnosis in clinic , preoperatively .Methods The clinical pathological and radiological data of 34 patients with renal hamartoma were retrospectively analyzed and , simultaneously , compared with those of 26 patients with renal clear cell carcinoma during the same period in our hospital , from December , 2009 to December 2014 .All patients underwent both CT and MRI scan . Results 1) In 34 cases of less fat renal hamartoma , CT scan showed that 6 cases presented with low density , 4 cases with mixed density , and 24 cases with slightly high density;Plain MRI scan showed that 10 cases exhibited homogenous low signal on T 2 , e-qual signal on T 1 .The enhanced scan showed that 34 cases were all uniform reinforcement , of which 20 cases exhibited moderate strengthening at cortical phase , 8 cases exhibited significantly enhancement , and 6 cases exhibited a transient reinforcement;2) In 26 cases of renal clear cell carcinoma , CT scan showed that 13 cases presented with low density , 7 cases with equidensity , and 6 cases with mixed density .The lesions were round or circular shape , with an average of 2.9~0.7 cm indiameter.MRI scan showed that 7 cases exhibited slightly higher signal on T 2 , low signal onT 1 .2 cases had psuedocapsule .Enhancement scanning showed that 15 patients exhibited with uneven reinforcement at cortical phase , 7 cases exhibited moderate strengthening , and the enhancement declined obviously at parenchymal phase and pelvic phase .Conclusion Application of CT scan on less fat renal hamartoma has certain characteristics and combined with MRI scan can improve differential diagnosis between the less fat renal hamartoma and renal clear cell carcinoma , which is helpful to clinical diagnosis and treatment of diseases .