肾脏上皮样血管平滑肌脂肪瘤的CT表现与病理基础

目的探讨肾脏上皮样血管平滑肌脂肪瘤（epithelioid angiomyolpoma，EAML）的CT影像学特征及病理基础。资料与方法搜集经手术病理证实的10例上皮样血管平滑肌脂肪瘤分析其临床及CT表现并复习相关文献。结果1O例均表现为圆形或类圆形的病灶，突出肾轮廓之外，CT平扫呈等或稍高于肾皮质。5例位于右肾，4例位于左肾，1例双肾多发。10例密度均不均匀，2例其内见大片囊变坏死，1例见点片状出血灶，3例含脂肪成分。6例边界清楚，4例边界不清，肾包膜受侵；4例直径大于6cm。增强扫描8例病灶实性部分均呈“快进快出”，2例富含脂肪成分病灶实质期见多发迂曲的血管。结论肾脏上皮样血管平滑肌脂肪瘤的CT表现具有一定的特征性，熟悉其影像学表现有助于诊断对该病。

CT Characteristics and Pathological Basis of Renal Epithelioid Angiomyolipoma

Objective To discuss CT features and pathological basis of renal epithelioid angiomyolipoma.Materials and Methods The clinical presentations and CT imging features of ten cases with primary renal epithelioid angiomyolipoma were analyzed.The pertinent literature on renal EAML is also reviewed.Results All of the ten cases showed round or oval lesions,prominent outside the renal contour,CT scan showed equal or slightly high idensity than the renal cortex.Five cases were located in the right renal,four cases in the left renal,one case showed multiple lesions in both kidneys.All of the ten cases showed uneven density,large areas of cystic and necrotic in two cases,one case was observed point and massive hemorrhage,three cases had fat density;six case were clear borders,four cases unclear borders,the renal capsule were invaded;four lesions were more than six centimeter in diameter,one lesion were less than six centimeter in diameter.The solid parts of eight lesions were quick-in and quick-out in enhanced CT scan,on parenchymal phase there were thicken and circuitous vessels in two lesions which are rich in fat.Conclusion CT imaging manifestations of primary renal epithelioid angiomyolipoma were found with certain characteristics,which may contribute to the diagnosis of the disease.