肾脏上皮样血管平滑肌脂肪瘤的螺旋CT表现及病理对照研究

目的：初步探讨肾脏上皮样血管平滑肌脂肪瘤的CT表现。方法：搜集4例经手术病理及免疫组化证实的肾上皮样血管平滑肌脂肪瘤，均行双肾螺旋CT平扫及动态增强扫描，回顾性分析其CT表现，并与手术病理对照。结果：2例CT平扫，含有明确脂肪密度，并呈侵袭性表现；增强扫描实性成分明显强化。2例病灶较小，平扫呈略高密度实性肿块，边界清楚，病灶内无明显脂肪密度；增强扫描密度相对均匀，实质期强化程度最高，排泄期密度下降较少。免疫组化均证实为上皮样肾血管平滑肌脂肪瘤。结论：肾脏上皮样血管平滑肌脂肪瘤即可富含脂肪，又可为乏脂肪病变，与经典血管平滑肌脂肪瘤在影像学上区分困难，当AML出现侵袭性表现，应考虑到肾脏上皮样血管平滑肌脂肪瘤。

Renal epithelioid angiomyoilpoma: the study of manifestation of spiral CT and pathology

Objective：To evaluate the spiral CT manifestation of renal epithelioid angiomyolipoma.Methods：The spiral CT findings in 4 eases of renal epithelioid angiomyolipoma proved by staining were analyzed and compared with pathology retrospeclively. Results： Fat nature can be detected on unenhanced CT scan in 2 cases with obscure boundary; Contrast-enhanced CT showed obviously and heterogeneously patchy enhancement of the lesions. Two eases showed slightly hyperdense on uninhanced CT scan and no fat nature could be detected. The masses were enhanced obviously in the parenchymal phase and slightly decreased in excretory phase. All of the 4 cases were proved renal epithelioid angiomyolipoma by immunohistochemieal staining. Conclusion： Renal epithelioid angiomyolipoma can contain abundant fat nature or absent of fat. It is difficult to identify renal epithelioid angiomyolipoma only through CT. It will be implied renal epithelioid angiomyolipoma when the invasive manifestation occurs in CT images.