肾脏嗜酸细胞腺瘤的螺旋CT诊断与病理对照分析.docVIP

肾脏嗜酸细胞腺瘤的螺旋CT诊断与病理对照分析 　　【摘要】 目的：分析肾嗜酸细胞瘤的多排螺旋CT增强扫描特征及病理表现，以提高诊断准确性。方法：对12例经手术后病理证实的肾嗜酸细胞腺瘤患者的多期增强CT影像学特点及病理结果进行回顾性分析。结果：11例为单发病灶，1例为多发病灶。病灶最大径20.0～87.0 mm，平均53.5 mm。1例行CT平扫显示肿瘤实质呈略高密度影，中心瘢痕呈低密度影。皮质期5例不均匀强化，6例肿瘤实性部分较均匀强化，所有病灶强化程度均高于髓质，低于皮质；实质期病灶强化程度均低于髓质，2例欠均匀强化，10例病灶密度趋向均匀强化；延迟期肿瘤实性部分整体密度较均匀强化并低于肾实质，与病理上该肿瘤较少发生出血、坏死、囊变相对应。其中1例双肾多灶病变亦遵循上述强化方式。6例见中央裂隙状或星芒状瘢痕，所有病例均未见钙化。结论：肾嗜酸细胞瘤是一种少见的肾脏良性肿瘤，多期螺旋CT增强扫描有一定影像学特点，如果能在术前提示到本病的可能性，可采取肾穿刺活检或手术中冰冻病理活检，对临床手术治疗方案的制定有重要参考意义。 　　【关键词】 肾嗜酸细胞腺瘤； 诊断； 螺旋CT； 病理 　　The Comprehensive Diagnosis of Renal Oncocytoma by Spiral CT and Pathology/ZHANG Qing，LI Jun-tang，ZHANG Jin-feng，et al.//Medical Innovation of China，2015，12（10）：124-129 　　【Abstract】 Objective：To analyze the problems in diagnosing renal oncocytoma by spiral CT and pathology， in order to improve the accuracy of diagnosis.Method：The imaging features of CT of 12 lesions confirmed by pathology were analysed retrospectively and correlated by pathologic diagnosis.Result：11 cases were single nodule， accompanying with the diameter of lesion was 20-87.0 mm， average 53.5 mm.ON plain CT scan，1 lesion showed a little higher density than the renal parenchyma，central stellate scar showed low density shadow.In the cortical phase， 5 cases displayed inhomogeneous enhancement，and 6 cases displayed homogeneous enhancement in part.The enhanced degree of all lesions were higher than that of medulla， and lower than that of cortex.In parenchymal phase， the enhanced degree of all lesions were lower than that of medulla.In excretory phase， the density of solid part of tumor was equation， and below that of the renal parenchyma， which was corresponding with the pathological feature：the tumor was less of hemorrhage，necrosis and cystic degeneration.The case of bilateral multiple renal lesions also followed the strengthening method.6 cases showed central slit shaped or stellate shaped scar，and all cases showed no calcification.Conclusion：Since renal oncocytoma is a kind of benign renal tumor， which