肾脏罕见良性肿瘤的影像学表现与临床病理对照分析

目的 分析肾脏罕见良性肿瘤的影像学表现.方法 回顾性分析15例经手术病理证实的肾脏罕见良性肿瘤的影像学资料,包括肾嗜酸细胞腺瘤5例,上皮样血管平滑肌脂肪瘤3例,孤立型纤维瘤3例,后肾腺瘤、血管瘤、平滑肌瘤和球旁细胞瘤各1例；其中12例接受CT检查,3例接受MR检查.结果 11例CT或MR平扫显示边界清楚的实性肿块.肾嗜酸细胞腺瘤明显不均匀强化,体积较大者可出现中央瘢痕.上皮样血管平滑肌脂肪瘤MR T1WI、T2WI均以低信号为主,内夹杂索条状、斑片状高信号以及流空信号.血管瘤呈渐进性向心性强化,易发生囊变；孤立型纤维瘤T1WI和T2WI均为低信号,增强后延迟强化.后肾腺瘤、平滑肌瘤和球旁细胞瘤缺少特征性影像学表现.结论 肾脏罕见良性肿瘤大多边界清晰,影像学表现多有一定特征性,对术前诊断有所帮助.

Imaging features of renal rare benign tumors: Comparison with clinical and pathological findings

Objective: To investigate the imaging features of renal rare benign tumors comparing with clinical and pathological results. Methods: Imaging materials of 15 patients with rare benign renal tumors were analyzed retrospectively, including renal oncocytoma (RO, n=5), epithelioid angiomyolipoma (EAML, n=3), solitary fibrous tumors (SFTs, n=3), metanephric adenoma (MA), hemangioma and leiomyoma and juxtaglomerular cell tumor (JCT, each n=1). Twelve patients underwent CT, and 3 underwent MR examination. Results: CT or MRI showed well-defined solid masses in 11 patients. Significant heterogeneously enhancement was characteristic performance of RO, and central scar could be found in large tumors. EAML revealed heterogeneous low-signal intensity on MR T1WI and T2WI with cable strip and patchy high signal and flow void signal intensity. Progressively centrality enhancement was marked in hemangioma, and cystic formations were common. SFTs showed low-signal intensity on MRI T1WI and T2WI, and demonstrated delayed enhancement on enhanced CT. Metanephric adenoma, leiomyoma and JCT were lack of characteristic imaging findings. Conclusion: The majority of rare benign tumors of kidney are well-defined. The imaging performance of various types of tumors has certain characteristics, which has important value in preoperative diagnosis.