多房囊性肾瘤的CT、MRI表现

目的探讨多房囊性肾瘤的CT、MRI表现,提高对多房囊性肾瘤影像学的认识。方法回顾性分析5例经手术病理证实的多房囊性肾瘤的CT和MRI资料并结合文献复习,讨论多房性囊性肾瘤的影像学表现及其病理基础。结果 5例多房囊性肾瘤均为单侧,直径从2.5-7.5cm不等,CT或MR扫描显示病灶囊壁完整,内由多个小囊腔和分隔构成,其中4例囊内分隔显示清晰,1例显示不清、边缘模糊。所有囊腔间无交通,囊壁和囊内分隔有不同程度的强化,均未见实质性结节。5例MR扫描在T1WI上呈低信号,T2WI为高信号,增强扫描延迟期囊壁及囊内分隔显示CT图像清晰。结论多房囊性肾瘤少见,CT和MRI能准确、全面地显示病灶的形态学特征,为明确诊断提供依据,但在和多房囊性肾癌等病变鉴别时仍有一定的难度。

The CT and MRI Features of Multilocular Cystic Nephroma

Objective To investigate the CT and MRI features of multilocular cystic nephroma and improve the understanding of the imaging manifestations of multilocular cystic nephroma. Methods Five cases of multilocular cystic nephroma were retrospectively analyzed by comparing the imaging findings with surgical and pathological results.Imaging signs were compared with pathologic results. The related literature was reviewed. Results In all five cases, multilocular cystic nephromas were unilateral and circumscribed by thick-capsules. These lesions ranged in diameter from 2.5 cm to 7.5 cm. Th e lesions were entirely composed of locules and septa without solid nodules. These locules did not communicate with each other. The septa of these lesions were clear in four cases and not very clear in one cases. All lesions were better detected on enhanced scans than on non-enhanced ones. Four of five cases also underwent MR scan, which presented low signal intensity on TIWI and high signal intensity on T2WI. The Interlocular septa was,demonstrated much better with MRI than with CT. Histopathology proved that the capsule and septa of the lesions were lined by cuboidal or flattened epithelial cells. Conclusion multilocular cystic nephroma is a rare disease of the kidney. CT and MRI scanning are valuable in the diagnosis of multilocular cystic nephroma, but the imaging features are not specific enough to differentiate benign multilocular cystic nephroma from multilocular cystic renal cell carcinoma.