梯度回波化学位移成像在肾细胞癌和肾血管平滑肌脂肪瘤中的诊断价值

目的探讨梯度回波化学位移成像在肾细胞癌(RCC)及肾血管平滑肌脂肪瘤(RAML)诊断中的价值。方法收集33例RCC和20例RAML,全部RCC病例和2例RAML经手术病理证实。所有病例均进行常规磁共振平扫及梯度回波化学位移成像。重点分析梯度回波化学位移成像序列中病变与肾实质、病变与肾周组织器官分界的成像特点。结果在反相位梯度回波序列中,RCC、乏脂肪的RAML病例与肾周脂肪、相邻组织器官的关系显示清楚;含有脂肪的RAML与肾实质分界显示清楚;5例RCC和18例RAML病例中的脂质成分均出现信号衰减。结论反相位梯度回波序列可以显示RCC与肾周组织器官的关系,对RCC的分期提供帮助;可以显示RAML内脂肪组织内部脂质的均匀程度。

Value of gradient-echo chemical shift imaging in diagnosis of renal cell carcinoma and renal angiomyolipoma

Objective To investigate the diagnostic value of gradient-echo chemical shift imaging on renal cell carcinoma(RCC) and renal angiomyolipoma(RAML).Methods Thirty-three cases of RCC and 20 cases of RAML(all cases of RCC and 2 cases of RAML were corroborated by surgery and pathology) admitted between September 2006 and June 2011 were recruited in this study.Magnetic resonance scanning and gradient-echo chemical shift imaging were performed in all cases.The analysis was laid stress on characteristics of gradient-echo chemical shift sequences imaging in the boundaries between the lesion and renal parenchyma,the lesion and perirenal tissues/organs.Results In opposed-phase gradient-echo sequence,the relations of RCC and fat-lacking RAML with perirenal fat and adjacent tissues/organs were displayed distinctly;the boundary between RAML of containing fat and renal parenchyma was showed clearly;the signal attenuation of lipid composition can be seen in 5 cases of RCC and 18 cases of RAML.Conclusions Opposed-phase gradient-echo sequence can display the relationship between the RCC and perirenal tissues/organs,and it is helpful to differentiate the stages of RCC.It can also display the distribution of the adipose tissue of RAML.