肾血管平滑肌脂肪瘤的影像学特征与术式选择

目的：探讨肾血管平滑肌脂肪瘤(RAML)影像学特征及术式选择。方法：对71例肾肿瘤患者．均行B超和CT检查．63例诊为RAML；9例诊断肾癌不排除．其中4例另行MRI联合诊断为RAML。除1例因肿瘤巨大肾实质较少、出血较多或怀疑恶性变而行肾切除，1例行选择性肾动脉栓塞术外．其余均行保留肾单位手术。结果：70例术中及术后病理诊断为RAML；1例术前B超和CT检查诊断为RAML．病程10年．肿瘤未有明显变化，但术中肉眼和术后病理诊断为“肾透明细胞癌”。11例术中阻断肾蒂患者．术后肾功能无明显异常。患者术后B超复查无肿瘤复发和转移。结论：B超和CT是诊断肾血管平滑肌脂肪瘤的重要手段．必要时呵辅助MRI联合诊断。除极少病例需要行肾切除术，RAML患者应尽量行保留肾单位术。

The radiological character and operation choice of angiomyolipoma

Objective:To evaluate the radiological character and operation choice of renal angiomyolipoma.Methods:The data of 71patients of RAML and literatures were reviewed. Preoperative ultrasonography and CT scanning have been undertaken in all. Renal angiomyolipoma was diagnosed in 63 and cancer could not be ruled out in the other 9. All cases except for 5 cases were performed Nephron-sparing surgery.Results:Seventy cases were diagnosed as RAML at operation and after operation. One case who was diagnosed as RAML with Ultrasonography and CT before operation was found to be renal cell carcinoma. No local tumor recurrence has been noted.Conclusions:Although some cases of angiomyolipoma may require complete nephrectomy, most can be managed by conservative nephron-sparing approaches.