肾嗜酸细胞瘤的CT表现

背景与目的：影像学检查是目前诊断肾嗜酸细胞瘤的重要方法。该研究总结肾嗜酸细胞瘤的CT表现，旨在提高临床医师对肾嗜酸细胞瘤的认识，提高诊断的准确性。方法：复旦大学附属肿瘤医院2008年7月—2017年10月术后病理学检查证实为肾嗜酸细胞瘤的患者共66例，术前在复旦大学附属肿瘤医院行腹部CT增强检查及CT检查前未行治疗和穿刺检查的共有17例，分析这17例患者的临床资料并总结CT特征。结果：17例患者中，男性9例，女性8例，年龄31~69岁，中位年龄59岁，均为单发病灶。肿瘤主要呈球形，最大径为18~100 mm，平均为（39.0±26.8）mm。增强扫描主要呈明显强化（16/17，94.1%），但强化程度一般低于肾皮质（平均肿瘤-皮质增强指数为0.78±0.19）。强化方式主要为持续强化型（15/17，88.2%）。7例（41.2%）出现星芒状瘢痕。5例（29.4%）出现“分段增强反演”现象。结论：肾嗜酸细胞瘤多为明显持续强化，有时伴有“分段增强反演”现象及星芒状瘢痕，这些CT特征可以提示肾嗜酸细胞瘤。

CT manifestations of renal oncocytoma

Background and purpose: At present, imaging examination is an important method for the diagnosis of renal oncocytoma. Our study summarized the CT manifestations of renal oncocytoma in order to promote clinicians’ understanding of renal oncocytoma and improve the accuracy of diagnosis. Methods: There were 66 patients with pathologically confirmed renal oncocytoma in Fudan University Shanghai Cancer Center from July 2008 to October 2017. Among them, there were 17 patients who underwent abdominal CT enhancement examination before operation without treatment or biopsy prior to CT examination. The clinical data and preoperative CT images of 17 patients were retrospectively reviewed. Results: Among the 17 patients, 9 patients were male and 8 patients were female. Patients’ ages ranged from 31 to 69 years, and the median age was 59 years. Each patient had a single lesion. Most tumors were spherical. The maximum diameter of tumors ranged from 18 to 100 mm, and the average maximum diameter was (39.0±26.8) mm. Most cases (15/17, 88.2%) showed obvious enhancement but less than the enhancement of renal cortex (average ratio of lesion-to-cortex attenuation: 0.78±0.19). Nephrographic phase images often showed a prolonged enhancement compared with the corticomedullary phase (15/17, 88.2%). There were 7 cases (41.2%) having stellate scar. Five cases (29.4%) showed segmental enhancement inversion. Conclusion: Most of the renal oncocytomas demonstrate obvious prolonged enhancement, sometimes accompanied by segmental enhancement inversion and stellate scars. These CT features may suggest the diagnosis of renal oncocytoma.