肾嗜酸细胞腺瘤螺旋CT诊断（附10例分析）

目的：总结肾嗜酸细胞腺瘤螺旋CT表现，为该病的术前诊断和手术方案选择提供依据。方法：分析10例经手术病理证实的肾嗜酸细胞腺瘤的螺旋CT表现。结果：（1）平扫6例最大直径小于3cm的肿瘤平扫时呈等密度，仅表现为肾轮廓局限性隆起；4例最大直径大于3cm的肿瘤密度不均匀。其中2例病灶内见斑点状钙化。（2）增强扫描5例较均匀强化，5例强化不均匀，其中4例在皮髓期病灶出现中央“星状瘢痕”。（3）全部病灶内实质成分强化程度均小于同期肾实质，在肾实质期测量、计算病灶-肾皮质强化比值为0．84（0．73～0．98）。（4）10例增强后行MIP、MPR重建显示9例肿瘤血供来自同侧肾动脉，1例血供来自腹主动脉。结论：肾嗜酸细胞腺瘤CT诊断困难，但是如果出现了一些特征性的征象（如“星状斑痕”征），应考虑到本病的可能性。结合术中病理检查，可避免不必要的肾脏根治性手术。

Diagnosis of Renal Oncocytoma by Spiral CT(Analysis of 10 Cases)

Objective：To summarize the spiral CT manifestation of renal oncocytoma and provide evidence for preoperative diagnosis of renal oncocytoma and choosing modus operandi. Methods：To analyze the spiral CT manifestation of 10 cases with renal oncocytoma confirmed by postoperative pathological characteristics. Results ：The pre-eontrast CT on 6 cases with the biggest diameter of tumors less than 3cm showed homogeneous shadows of tumors, which looked like renal outline swelling up. However,other 4 cases with tumorous longest diameter greater than 3 cm showed inhomogeneous density of tumors, among which 2 cases displayed some stippled caleifation inside tumors. The enhancement scanning demonstrated that homogeneous density in 5 eases, and inhomogeneous in other 5 cases, amongst which 4 displayed some ＂stellate scar＂ in the centers of tumors in corticomedulary phase. Solid component in all lesions were less enhanced than normal renal parenchyma in same phase. The enhancement ratio of the lesion to renal cortex was 0.84 （0.73 -0.98）in parenchymal phase. The MIP and MPR reconstruction after enhancement showed that 9 eases obtained blood supply from homonymy renal arteries, another one from abdominal aorta. Conclusions：Renal oncocytoma is difficult to diag- nose by CT. But it should be considered as renal oneocytoma when some distinctive signs （ such as central ＂stellate scar＂ ） appearing. Combination with intraoperative pathologic examination maybe avoid some unwanted renal radical operations.