外生性肾血管平滑肌脂肪瘤与肾周脂肪肉瘤的CT特征分析

摘要

目的 分析外生性肾血管平滑肌脂肪瘤与肾周脂肪肉瘤的CT征象及鉴别要点.方法 回顾性分析本院经病理证实的20例外生性肾血管平滑肌脂肪瘤及20例肾周脂肪肉瘤的CT表现,使用两独立样本t检验及Fisher确切概率法对两者间的CT表现进行统计学分析.结果 20例外生性肾血管平滑肌脂肪瘤中:肿瘤与肾脏交界面的肾皮质缺陷("杯口征")20例,瘤内血管扩张18例,肿瘤血管延伸至肾实质(肾实质血管蒂)20例,肿瘤血供来自肾动脉分支20例,合并瘤内或(和)周围出血6例,合并其他血管平滑肌脂肪瘤5例.以上这6种征象,多见于或仅见于外生性血管平滑肌脂肪瘤(P均<0.05).20例肾周脂肪肉瘤中:肿瘤内乏脂肪软组织结节20例,伴有肾位移19例,这2种征象多见于或仅见于肾周脂肪肉瘤(P均<0.05).外生性肾血管平滑肌脂肪瘤肿块大小通常小于肾周脂肪肉瘤(P<0.05).两者之间的性别分布以及钙化发生率无统计学差异(P均>0.05).结论 特异性的CT表现有助于鉴别外生性肾血管平滑肌脂肪瘤与肾周脂肪肉瘤,为临床治疗提供更为准确的影像学依据.%Objective To compare the CT findings of exophytic renal angiomyolipoma and perirenal liposarcoma.Methods CT data of 20 patients with exophytic renal angiomyolipoma and 20 pateints with perirenal liposarcoma were reviewed by two radiologists blinded to the clinical and pathological findings.These findings were compared between exophytic renal angiomyolipoma and perirenal liposarcoma using the Student t-test and Fisher 's exact test.Results Exophytic renal angiomyolipomas were smaller (P <0.05)and more commonly showed the following findings(P <0.05):renal parenchymal defect in 20 patietns,aneurysmal dilatation of intratumoral vessels in 18 patients,renal parenchymal vascular pedicle in 20 patients,supply of renal artery branches in 20 patients,hemorrhage in 6 patietns and combination with other intrarenal fatty lesions in 5 patients.Whereas,the findings associated with perirenal liposarcoma were non-fat soft tissue node in 20 patients (P <0.05)and kidney displacement in 19 patients (P <0.05).No significant difference was seen in calcification and sexuality(P >0.05).Conclusion Several CT findings were significantly different between exophytic renal angiomyolipoma and perirenal liposarcoma,which can be helpful for differentiating the two tumors,and provides the accurate imaging basis for the next therapy.