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肾脏乏脂肪血管平滑肌脂肪瘤的临床病理及CT表现
引用本文:贺新华,丁玉芹,陈亮,刘锴,缪熙音,罗荣奎,周建军,曾蒙苏. 肾脏乏脂肪血管平滑肌脂肪瘤的临床病理及CT表现[J]. 放射学实践, 2014, 0(6): 673-676
作者姓名:贺新华  丁玉芹  陈亮  刘锴  缪熙音  罗荣奎  周建军  曾蒙苏
作者单位:贺新华 (如皋市人民医院影像科, 江苏,226500); 丁玉芹 (复旦大学附属中山医院放射诊断科/上海市影像医学研究所, 上海,200032); 陈亮 (复旦大学附属中山医院放射诊断科/上海市影像医学研究所, 上海,200032); 刘锴 (复旦大学附属中山医院放射诊断科/上海市影像医学研究所, 上海,200032); 缪熙音 (复旦大学附属中山医院放射诊断科/上海市影像医学研究所, 上海,200032); 罗荣奎 (如皋市人民医院 病理科, 江苏,226500); 周建军 (复旦大学附属中山医院放射诊断科/上海市影像医学研究所, 上海,200032); 曾蒙苏 (复旦大学附属中山医院放射诊断科/上海市影像医学研究所, 上海,200032);
摘    要:
目的:探讨肾脏乏脂肪血管平滑肌脂肪瘤(AML)的临床、病理及CT 表现特征。方法:回顾性分析36例经手术病理证实的乏脂肪AML 的临床、病理及 CT 资料,将其分为上皮样血管平滑肌脂肪瘤(EAML)组和其他乏脂肪A ML组,观察病灶的数目、大小、形状、密度及其均匀性、劈裂征、血管影、假包膜、病灶的强化程度及强化方式等,采用SPSS 19.0软件进行统计学分析。结果:EAML组18例19灶,平均年龄40岁,其他乏脂肪AML 组18例22灶,平均年龄49岁。两组病灶最大径分别为(58.63±56.59)mm和(16.97±8.59)mm,P<0.05;密度不均匀者分别为10例和4例, P<0.05;形态不规则者分别为12例和10例,劈裂征阳性者分别为8例和13例,血管影分别为6例和2例,假包膜分别为6例和2例;病灶强化方式快进快出者分别为4例和10例,持续性强化者分别为14例和12例,渐进性强化者分别1例和0例,两组间病灶形状、劈裂征、血管影、假包膜均无统计学差异。EAML组病灶平扫、皮髓质期和肾实质期CT值分别为(44.3±10.7)HU、(101.6±26.6)HU 和(86.9±17.9)HU,其他乏脂肪AML 组各期CT 值分别为(37.1±7.3)HU、(108.7±23.8)HU和(87.6±13.6)HU。EAML组比其他乏脂肪AML组平扫CT值高,P<0.05,增强后CT 值无统计学差异。结论:乏脂肪AML CT表现有一定特征性,EAML较其他乏脂肪AML发病年龄小,病灶体积大,平扫密度相对高且不均匀,明确诊断依赖于病理。

关 键 词:肾肿瘤  平滑肌瘤,上皮样  体层摄影术,X线计算机  病理学

Clinical,pathological and CT features of lipid-poor renal angiomyolipoma
Affiliation:HE Xin-hua, DING Yu-qin, CHEN Liang, et al.( Department of Radiology, People's Hospital of Rugao City,Jiangsu 226500, P. R. China)
Abstract:
Objective:To investigate the clinical,pathological and CT features of lipid-poor renal angiomyolipoma (AML).Methods:The clinical,pathological and CT data of 36 patients with pathologically proven lipid-poor renal AML were retrospectively analyzed and divided into two groups:epithelioid anigomyolipoma (EAML)and non-EAML.The number,size,shape,density and uniformity,crack sign,vessel sign,pseudocapsule,enhancement degree and pattern of the lesions were observed and documented.Statistical analysis was performed by use of IBM SPSS 19.0.Results:There were 18 patients of 19 lesions in the EAML group with an average age of 40 years and 18 patients of 22 lesions in the non-EAML group with an average age of 49 years.The maximum diameter of the lesions was (58.63±56.59)mm in EAML and (16.97±8.59) mm in non-EAML (P〈0.05)respectively;lesions with CT inhomogeneity was 10 and 4 (P〈0.05).Irregular shape was 12 and 10.Crack sign was 8 and 13.Vessel sign was 6 and 2 Pseudocapsule sign was 6 and 2.Wash-in and washout enhancement was 4 and 10.Prolonged enhancement was 14 and 12.Gradual enhancement cases was 1 and 0.Lesion shape,crack sign,vessel sign and pseudocapsule between the two groups were not statistically different.The CT values of the lesion in plain scan,corticomedullary and parenchymal phase were (44.3±10.7)HU,(101.6±26.6)HU and (86.9±17.9)HU in EAML,and (37.1±7.3)HU,(108.7±23.8)HU and (87.6±13.6)HU in non-EAML.CT values of the lesions in plain scan were higher in EAML (P〈0.05).However,there was no statistical significance in contrast enhancement.Conclusion:There are certain CT characteristics in lipid-poor AML.EAML is larger in size,higher in attenuation on the plain scan and more inhomogeneous compared with non-EAML with younger onset age.The final diagnosis depends on pathology.
Keywords:Kidney neoplasms  Leiomyoma,emithelioid  Tomography,X-ray computed  Pathology
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