特殊病理类型肾脏血管平滑肌脂肪瘤的CT和MRI表现

目的:探讨肾脏少见病理类型的血管平滑肌脂肪瘤的CT、MRI影像表现,提高对该病变的影像表现认识。方法:回顾性分析6例经手术病理证实的肾脏不典型血管平滑肌脂肪瘤的CT、MRI影像资料,分析其病灶大小、部位、边界、CT平扫及增强表现和MRI信号特征以及肝、肾的伴发病灶等。结果:肿块来源肾实质,可突出肾轮廓或贯穿肾实质,边界光整;CT、MRI平扫肿块呈混杂密度或信号,MRT2WI病灶内可见与肌肉相似的稍低信号,肿块内常伴囊变、出血,可见假包膜、钙化,但均无明显脂肪密度或信号;增强扫描皮质期呈轻中度强化。结论:肾脏不典型血管平滑肌脂肪瘤CT、MRI表现多样,灶内无明显脂肪是其共性,病灶边界光整,MRT2WI病灶内见与肌肉相似的稍低信号影可提示诊断,但最后确诊仍需依赖病理。

The CT and MRI Features of An Unusual Clinicopathological Type of Angimyolipoma in the Kidney

Objective:To improve CT and MRI diagnosis and pathologic knowledge of atypical angiomyolipoma in the kidney.Methods:6 cases of atypical angiomyolipoma in the kidney proved by surgery and pathology were analysed retrospectively,including the features of CT and MRI on enhanced scan,unenhanced scan and accompanied other lesions in kidney or liver.Results:Lesions originated from renal parenchyma protruded from the outline of kidney and showed homogeneous density or signal and hypointense signal on T_2WI images with smooth margin,other characteristics included calcification,hemorrhage,necrosis,cystic change and pseudocapsule but no fat component.Conclusion:Its imaging features are various.Lesions of less or no fat component,smooth margin,hypointense signal as muscle on T_2WI images are significant clue to the diagnosis of atypical angiomyolipoma in the kidney,the definite diagnosis still depends on pathological examination.