肾嗜酸细胞腺瘤的动态增强CT征象分析

Analysis of the dynamic enhancement CT signs of renal oncocytoma

关键词:  肾肿瘤  嗜酸细胞腺瘤  体层摄影术  X线计算机

Key words:  kidney neoplasm  oncocytoma  tomography  X-ray computed

摘要:

［目的］探讨动态增强CT对肾嗜酸细胞腺瘤术前诊断的价值。［方法］回顾性分析经手术、病理证实的13例肾嗜酸细胞腺瘤的动态增强CT表现，记录病灶部位、大小、密度、边缘、强化形式，分别测量病灶在CT动态增强各期的CT值。［结果］CT平扫：13例肾嗜酸细胞腺瘤平均直径4.64 cm，3例密度均匀，7例病灶内见瘢痕样低密度影，3例密度不均匀，其中2例见小囊状低密度灶。动态增强CT：13例病灶实质部分CT值在皮质期平均94 Hu、实质期平均110 Hu、排泄期平均90 Hu；7例病灶的中心瘢痕呈轻微强化，其中3例皮质期可见粗大、迂曲血管影；2例病灶表现为皮质期至排泄期的节段性强化逆转，5例包膜轻度延迟强化。［结论］在动态增强CT影像上，肾嗜酸细胞腺瘤具有明显持续强化、星状瘢痕、包膜延迟强化、少数囊变、节段性强化逆转或显示皮质期粗大血管影等特点，有助于其术前诊断和与肾癌相鉴别。

Abstract:

［Objective］To investigate the value of dynamic enhancement CT in the preoperative diagnosis of renal oncocytomas.［Methods］The tumor signs on dynamic enhancement CT,including the location,size,density,margin,the patterns of enhancement and CT values on dynamic enhancing phases were observed retrospectively.［Results］Plain scan revealed that average diameter of 13 tumors was 4.64 cm.Five of them were encapsulated,7 of them were with central stellate scar,3 homogeneous and 3 heterogeneous.Dynamic enhancement scan indicated that solid portion of the tumors were persistent enhancement obviously,with the average CT values of 94 Hu,110 Hu,90 Hu,respectively at cortical,parenchymal and excretory phase.The central stellate scar had light enhancement.Three oncocytomas showed thick vessel shadows in them at cortical phase.Two cases presented segmental enhancement inversion.［Conclusions］Renal oncocytomas have certain features on dynamic enhancement CT,which helps to differentiate the tumor from renal carcinoma preoperatively.