肾周脂肪肉瘤与肾脏巨大血管平滑肌脂肪瘤的CT和MRI鉴别诊断价值

目的评价CT和MRI对肾周脂肪肉瘤与肾脏巨大血管平滑肌脂肪瘤(AML)的鉴别诊断价值。资料与方法搜集经手术病理证实的肾周脂肪肉瘤18例和肾脏巨大AML(直径>8cm)14例患者资料。32例均行CT检查,10例同时行MRI检查,分析脂肪肉瘤和AML的影像学特点。结果AML有14例显示肾实质缺损、11例发现瘤内扩张血管、5例肿瘤出血及3例伴有更小AML;而脂肪肉瘤无肾实质缺损、出血及不伴有更小AML征象,仅1例发现瘤内血管。肾实质缺损、瘤内扩张血管及肿瘤出血对鉴别两者差异有统计学意义。结论肾实质缺损、瘤内血管和出血是肾周脂肪肉瘤与肾脏巨大AML鉴别的重要影像学征象。

The Value of CT and MRI in Differentiation of Perirenal Liposarcomas and Large Exophytic Angiomyolipomas

Objective To evaluate the value of CT and MRI in the differentiation of large exophytic angiomyolipomas(AML)and perirenal liposarcomas.Materials and Methods 14 patients with AML and 18 patients with perirenal liposarcomas confirmed pathologically were examined by CT(n=32)and 1.5T MRI(n=10).The characteristics of CT and MRI were evaluated and compared.Results AML showed renal parenchymal defect(n=14),intratumoral vessels(n=11),hemorrhage(n=5),and additional small angiomyolipomas(n=3).However none of liposarcomas showed renal parenchymal defect,hemorrhage,or associated angiomyolipomas,and only 1 case showed intratumoral vessels.There was significant difference in the presence of renal parenchymal defect,intratumoral vessels and hemorrhage between large exophytic angiomyolipomas and perirenal liposarcomas.Conclusion Renal parenchymal defect,intratumoral vessels and hemorrhage are useful imaging signs to differentiate large AML from liposarcomas.