肾脏少见原发肿瘤的CT诊断

目的探讨肾脏少见原发肿瘤的CT表现特征,以提高术前诊断准确率。方法回顾性分析经病理证实的10例肾脏少见原发肿瘤的CT及临床资料,结合文献分析肾脏少见原发肿瘤的CT表现特征。结果癌肉瘤1例,CT平扫呈不规则形混杂密度影,内见多发坏死、囊变及钙化,边界清;增强扫描呈“花瓣状”强化。淋巴瘤2例,表现为巨大软组织肿块,无包膜,边界不清;增强扫描呈均匀强化,见“血管漂浮征”。孤立性纤维性肿瘤2例,密度均匀,边界清晰,增强扫描皮髓期轻度不均匀强化,实质期、肾盂期呈进行性强化。平滑肌肉瘤5例CT平扫呈等、低密度影,边界清,突向肾外生长,4例(直径>5cm)密度不均匀,1例(直径<5cm)密度均匀;增强扫描5例均呈轻~中度、持续性强化。结论CT增强扫描对肾脏少见原发肿瘤的术前诊断有重要提示意义。

The CT diagnosis of rare primary renal tumors

Objective To describe CT imaging features of rare primary renal tumors,so as to improve the accuracy of diagnosis.Methods The clinical and CT imaging findings of 10 rare primary renal tumors confirmed by pathology were retrospectively analyzed and literatures were reviewed.Results Carcinosarcoma(1 case)it was irregular shape with clean boundary and mixed density which contained several cystic necrotic areas and calcifications.It showed“petal-like”enhancement.Lymphoma(2 cases)there were large and irregular soft tissue masses with no capsules and unclear boundaries on plain CT.They showed mild to moderate homogeneous enhancement,with“vascular floating sign”in them after contrast administration.Solitary fibrous tumors(2 cases)both of the tumors showed homogeneous iso-density with distinct margins.They demonstrated mild and heterogeneous enhancement in corticomedullary phase and progressive enhancement in parenchymal and pelvic phase.Leiomyosarcoma(5 cases)they had hypo-/iso-attenuation with defined boundary and mainly protruded outwards from the renal contour.4 cases(diameter>5 cm)had heterogeneous density with lots of cystic necrosis and 1 case(diameter<5 cm)had homogeneous density.They all showed mild to moderate and delayed enhancement.Conclusion Enhanced CT scan has important implications for preoperative diagnosis of rare primary renal tumors.