摘要
目的探讨乏脂肪肾错构瘤的螺旋CT表现。方法本组6例,男5例,女1例,均为单肾单个病灶,其中右肾2例,左肾4例。先行双肾常规CT平扫,然后行螺旋CT动态增强扫描。6例均行手术切除,并做病理检查。结果6例均表现为实性肿块,大小由2.2cm×2.5cm～8.0cm×10.0cm,CT片上瘤内均未见脂肪性低密度。平扫4例呈等密度,1例呈稍低密度,1例密度稍高。增强扫描3例肾皮质期肿瘤明显强化,2例肾皮质期肿瘤轻度强化,1例瘤内见少量强化血管。病理证实4例为肾血管平滑肌脂肪瘤,2例为肾血管平滑肌瘤。结论当瘤内血管成分居多时,螺旋CT动态增强扫描肿瘤常表现为一过性明显强化,应与多血供肾癌鉴别;当瘤内平滑肌成分居多时,肿瘤轻度强化,需注意与少血供肾癌及其他肾脏良性肿瘤鉴别。
Objective To evaluate the spiral CT manifestations of renal angiomyolipoma absent of fat. Methods The spiral CT findings in 6 cases of renal angiomyolipoma histopathologically proved were analyzed and compared with pathology retrospectively. Results No fat nature could be detected on CT scan in all of the 6 cases. Five cases showed iso-dense or slightly hypodense on unenhanced CT, another case showed slightly hyperdense on account of bleeding of tumor. After the administration of intravenous contrast material, 3 cases enhanced obviously in corticomedullary phase and decreased in attenuation during nephrographic phase. Two cases enhanced slightly in corticomedullary phase, one of them showed many enhanced vessels and lasted hyperattenuation during nephrographic phase. Another showed a few vessels inside tumor. The enhancement of one case couldn＇t be decided correctly for bleeding of tumor. Conclusion The renal angiomyolipomas absent of fat were always misdiagnosed on account of no fat attenuation was detected on CT. Hypervascular renal angiomyolipomas （absent of fat ） always manifest transient hyperattenuating, they should be differentiated with hypervascular renal carcinoma. When the tumors are plenty of smooth muscle, they enhance slightly. This kind of renal angiomyolipoma （absent of fat） should be differentiated with hypovascular renal carcinoma and other benign renal neoplasms.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2005年第10期1101-1103,共3页
Chinese Journal of Radiology
