低度恶性潜能多房囊性肾肿瘤的MRI表现及临床分析

目的 探讨低度恶性潜能多房囊性肾肿瘤的MRI表现及临床特点.方法 回顾性分析5例经病理学证实的低度恶性潜能多房囊性肾肿瘤的MRI表现及临床资料.结果 5例均为单发,3例呈类圆形,2例呈分叶状.肿瘤边界均较清晰,最大直径约15 ～54 mm.MRI平扫囊壁及囊内分隔较薄而欠均匀,厚约1～3 mm,呈T1 WI等及稍高信号,T2WI为较低信号;囊液T2WI均为高信号,T1WI 4例为不均匀较低信号,1例低信号中见絮状稍高信号.DWI显示,2例囊壁及囊内分隔见点、条状较高信号,3例为等信号.动态增强囊壁及囊内分隔2例皮质期见较明显强化点、条状影,实质期及排泄期强化减弱;其余3例不均匀中等强化弱于肾皮质,实质期及排泄期均明显延迟强化.5例均未见邻近侵犯及转移.临床3例出现腰部隐痛及镜下血尿,2例无明显症状.5例术后随访18 ～36个月,均未见复发及转移.结论 低度恶性潜能多房囊性肾肿瘤恶性程度低,手术治疗效果好.MRI对其诊断具有较大价值.

MRI findings and clinical manifestation of multilocular cystic renal cell neoplasm with low malignant potential

Objective To analyze the MRI findings and clinical manifestations of multilocular cystic renal cell neoplasm with low malignant potential.Methods The MRI findings and clinical data of 5 cases of pathologically identified multilocular cystic renal cell neoplasm with low malignant potential were analyzed retrospectively.Results All 5 cases consisted of single tumor,3 were oval-shaped and 2 were irregular-shaped with lobes,which had clear boundary with a maximum diameter of 15-54 mm.Unenhanced MRI found that the cystic wall and septa inside tumors were slim and asymmetrical,with a thickness of 1-3 mm.T1WI showed medium to high signal,and T2WI showed low signal.The liquid inside the neoplasm showed high signal on T2WI.The liquid showed uneven low signal in 4 cases and cotton-shaped medium to high signal in one case on T1WI.DWI suggested punctated or striped medium to high signal on the cystic wall and septa inside the tumors in 2 cases,and equal signal in 3 cases.On enhanced MRI,the cystic wall and septa inside tumors showed obviously enhanced dotted and striped shadow on the cortical phase,and attenuated signal on the virtual and excretive phases in 2 cases.The rest 3 tumors showed uneven medium enhancement (lower than renal cortex) on the cortical phase,and continued delayed enhancement on the virtual and excretive phases.Invasion or metastasis to adjacent tissue was not observed in all 5 cases.Clinically,3 cases showed abdominal distension and microscopically hematuria,and the rest 2 cases showed no obvious symptoms.All 5 cases received surgical treatment,and were followed up for 18-36 months.No recurrence or metastasis was reported.Conclusion Multilocular cystic renal cell neoplasm with low malignant potential is a type of low-grade malignant tumor.It can be diagnosed by MRI scan and has a favorable prognosis after surgical treatment.