肾血管平滑肌脂肪瘤的CT诊断 附31例报告

　　【摘要】 目的 提高肾血管平滑肌脂肪瘤(angiomyolipoma, AML)的CT诊断水平。方法 回顾性分析31例肾AML患者的临床资料并探讨其CT诊断。结果 CT检查发现含脂肪成分者26例，其中常规层厚发现脂肪成分20例，薄层发现(常规不能确定的)脂肪成分6例;CT检查无明显脂肪成分者5例，其中MRI检查T1WI呈等信号、T2WI呈低信号确诊为肾AML 2例，误诊为肾癌2例，不能定性1例，该3例术中行冰冻活检确诊为肾AML。结论 CT对肾AML诊断的关键是在肿瘤中测得脂肪密度影，对于少脂或无脂的AML，薄层CT 扫描可提高诊断准确率;CT结合MRI、B超检查可使确诊率明显提高;术中冰冻活检对明确诊断有决定性意义。

　　【关键词】 肾血管平滑肌脂肪瘤;体层摄影术，X线计算机;误诊

　　CT diagnosis of renal angiomyolipoma: a report of 31 cases

　　QI Mei1, CHEN Changqing2*, TANG Ping3, GONG Min2, HU Wei2

　　(1. Department of Radiology, Nanhui Branch, Huashan Hospital of Fudan University, Shanghai 201300, China;

　　2. Department of Urology, Nanhui Branch, Huashan Hospital of Fudan University;

　　3. Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040)

　　Abstract:Objective To improve the proficiency in CT diagnosis of the renal angiomyolipoma (AML).Methods Clinical data of 31 cases of renal AML were retrospectively analyzed and discussed.Results CT scan confirmed adipose tissue in 26 cases, of which 20 cases were detected by routine slice scan and 6 cases detected by lamellar scan (undetermined by routine slice scan). CT scan revealed absence of evident adipose tissue in 5 cases, of which 2 cases were diagnosed as AML with MRI examination indicating isointensive signal on T1WI and hypointensive signal on T2WI, and 2 cases were misdiagnosed as renal carcinoma, and 1 case was undetermined. The latter 3 cases were diagnosed as AML by intraoperative frozen biopsy.Conclusion The detection of fatty density is the key to the diagnosis of AML. In lesions with little adipose tissue, lamellar CT scan can contribute to the accuracy of diagnosis. CT in combination with MRI and ultrasonography type B could markedly enhance the accuracy of AML diagnosis. In addition, intraoperative frozen biopsy is critical to accurate diagnosis.

　　Key words： renal angiomyolipoma; tomography, X-ray computed; misdiagnosis

[1] [2] [3] 下一页