脑梗死患者溶栓治疗过程中脑微出血的影响因素分析.docVIP

脑梗死患者溶栓治疗过程中脑微出血的影响因素分析 　　【摘要】目的探讨肾血管平滑肌脂肪瘤（RAML）的CT和MRI影像特征，提高术前确诊率。 　　方法回顾性分析经手术或穿刺活检确诊的13例RAML患者共15个病灶的CT和MRI影像学特征，并对比病理结果。 　　结果CT和MRI检查诊断：单肾发病11例，双肾2例；肿瘤直径5 cm的5个病灶，其中合并肝血管平滑肌脂肪瘤（HAML）2例；以脂肪密度为主的病灶8个，乏脂肪或无脂肪成分病灶7个，其中2例CT误诊为肾细胞癌（RCC）。13例术后或穿刺病理均确诊为RAML，8个病灶富脂肪性，5个病灶乏脂肪性和2个病灶无脂肪性。 　　结论CT及MRI对富脂肪性RAML均容易明确诊断，但CT对于乏或无脂肪RAML易误诊为RCC。MRI多参数多序列成像对RCC鉴别具有优势，CT诊断乏脂肪RAML有困难时应加做MRI检查和穿刺确诊。 　　【关键词】肾血管平滑肌脂肪瘤；CT；MRI；影像研究 　　中图分类号：R737.11文献标识码：ADOI：10.3969/j.issn2016.02.022 　　【Abstract】ObjectiveTo explore CT and MRI imaging characteristics of renal angiomyolipoma（RAML），so as to improve rate of confirmed diagnosis before operation. 　　MethodsCT and MRI imaging characteristics of 15 lesions in 13 patients who were confirmed with RAML by surgery or biopsy were retrospectively analyzed，and pathological findings were compared. 　　Results CT and MRI diagnosis showed that single kidney disease were found in 11 cases，double kidney in 2 cases；10 lesions with diameter of tumor5 cm，among which 2 cases were complicated with hepatic angiomyolipoma（HAML）.8 lesions dominated by fat density，7 lesions lacked of fat or fat ingredients，among which 2 cases were misdiagnosed with renal cell carcinoma（RCC）.13 cases were diagnosed with RAML by operation or biopsy pathology，8 lesions had abundant fat，5 lesions lacked of fat，and 2 lesions had no fat. 　　ConclusionCT and MRI can easily diagnose RAML with abundant fat，but to RAML lacked of fat or fat ingredients，CT can easily misdiagnosed with RCC.Multiparameter sequence MRI imaging for RCC has an advantage，when CT has difficulties in diagnosing RAML with abundant fat，MRI examination and biopsy should be used to make a definite diagnosis. 　　【Key words】RAML；CT；MRI；imaging studies 　　肾血管平滑肌脂肪瘤（RAML）又称为肾错构瘤，是肾脏良性肿瘤，主要由不同比例的脂肪组织、平滑肌及血管组成。对富脂肪性RAML影像诊断不难，但乏脂肪性RAML容易误诊为肾癌。现回顾性分析13例经手术或穿刺活检证实的RAML患者的CT及MRI资料，以探讨本病的 CT及MRI影像表现和诊断价值。 　　1资料与方法 　　1.1一般资料 　　在进修学习期间收集广西壮族自治区人民医院 2012年1月至2015年1月门诊及住院的13例RAML患者共15个病灶，男性5例，女性8例，年龄18～76岁，平均47.5岁；单肾发病