非典型肾血管平滑肌脂肪瘤的影像诊断

目的分析肾脏无或少脂肪血管平滑肌脂肪瘤的影象学表现,探讨CT和MRI在其鉴别诊断中的价值。方法回顾分析13例经手术病理证实的非典型肾血管平滑肌脂肪瘤的影象学表现,所有病例均做CT检查,其中6例做MRI检查。结果肾血管平滑肌脂肪瘤13例共15个病灶,其中仅4例含少量脂肪成分,余所有病例均未见明显脂肪成分。CT平扫除4例呈等密度外,余均呈略高密度,动态增强扫描在肾皮质期呈明显均匀强化。MRI显示所有肿瘤在T2WI脂肪抑制时均呈低信号。结论非典型肾血管平滑肌脂肪瘤易与和肾癌相混淆,CT表现具有一定的特征性和鉴别诊断价值,如鉴别诊断仍有困难,应做MRI检查以提供进一步的诊断依据。

Imaging Diagnosis of Atypical Renal Angiomyolipoma

Objective To analyze the imaging manifestation of atypical renal angiomyolipoma(RAML) and to discuss the value of CT and MRI in the antidiastole.Methods A retrospective analysis was made to the imaging manifestation of 13 cases with atypical renal angiomyolipoma pathologically confirmed by surgery,all the cases had CT and MRI was added to 6 cases.Results Except the 4 lesions out of the 15 lesions in 13 cases with RAML with little fat component,all the rest showed no obvious fat component.The CT scanning showed all lesions with high density except 4 lesions with isodensity while the dynamic-enhanced scanning showed all lesions with obvious even enhancement.MRI showed all lesions with low signal when T2WI fat suppression existed.Conclusion It is often to confuse atypical renal angiomyolipoma with renal cancer;CT manifestation is of certain marks and antidiastole value;when antidiastole is uncertain,MRI should be given to provide further diagnosing proof.