肾脏原发恶性孤立性纤维瘤的CT特点

目的 探讨肾脏原发恶性孤立性纤维瘤(MSFT)CT特点。方法 回顾性分析本院经手术病理证实的5例肾脏MSFT患者的临床和CT表现。结果 肿瘤位于右肾4例,左肾1例;4例来源于肾被膜,1例起自肾实质;均呈类圆形,边界清楚,见包膜,长径5.1~18.3 cm。CT平扫均呈低密度,2例见点状钙化灶,1例病灶多发且位于一侧肾脏。5例增强扫描均为皮髓期轻度强化,实质期及排泄期持续性不均匀强化,且内部见囊变坏死区。结论 当肾脏CT检查发现类圆形、边界清楚、有包膜、体积较大的肿块,瘤体内出现坏死、囊变、钙化或多发病灶,且平扫及增强扫描肿瘤密度低于周围正常肾实质密度,出现渐进性"地图"样强化时,应考虑肾脏MSFT的可能。

CT features of malignant solitary fibrous tumor in kidney

Objective To evaluate the CT characteristics of malignant solitary fibrous tumor (MSFT) of the kidney. Methods CT findings and clinical data of 5 patients with MSFT of the kidney pathologically proved were analyzed retrospectively. Results Four cases located in the right kidney and 1 case in the left kidney. Four cases originated in the renal capsule, and 1 case in the renal parenchyma. All of the tumors were oval, well-defined border and perfect tumor capsular. Maximum diameter of lesions ranged from 5.1 cm to 18.3 cm. CT plain scan showed low density in all the cases. Two cases were found spot calcification inside tumor lesions and 1 case was found multiple foci located in the same kidney. After contrast administration, tumor lesions showed mild enhancement in the cortical-medullar phase and revealed granularly continuous enhancement in the nephrographic phase and excretory phase with cystic degeneration and necrosis. Conclusion MSFT should be enrolled into accounts when renal CT scan finds oval, well-defined border and perfect tumor capsular lesion, accompany with spot calcification, cystic and multiple, especially the density lower than the surrounding renal parenchyma on unenhanced and contrast-enhancement CT scan with map-like granularly continuous enhancement.