外生性肾血管平滑肌脂肪瘤与腹膜后脂肪肉瘤的CT征象分析

Exophytic renal angiomyolipoma vs retroperitoneal liposarcoma: CT features analysis

目的探讨CT征象能否准确诊断与鉴别外生性肾血管平滑肌脂肪瘤与腹膜后脂肪肉瘤。方法回顾性分析17例外生性肾血管平滑肌脂肪瘤和7例腹膜后脂肪肉瘤的MDCT图像,使用Fisher确切概率法对CT征象与两种肿瘤之间的关系进行比较。结果肿块与肾脏交界面的肾皮质缺损、肿块内粗大血管、肾动脉分支供血及肿块内血管穿过肾实质走行仅或主要见于外生性肾血管平滑肌脂肪瘤(P均<0.01);肾脏向前移位和肿块内非脂肪成分强化结节灶仅或主要见于腹膜后脂肪肉瘤(P均<0.01)。钙化、肿块内和(或)周围出血及合并的其他血管平滑肌脂肪瘤在外生性肾血管平滑肌脂肪瘤和腹膜后脂肪肉瘤中的差异并无统计学意义(P均>0.05)。结论 CT征象能有效鉴别外生性肾血管平滑肌脂肪瘤与腹膜后脂肪肉瘤。

Objective To investigate the reliability of CT features in distinguishing exophytic renal angiomyolipoma from retroperitoneal liposarcoma.Methods CT images of 17 patients with exophytic renal angiomyolipoma and 7 with retroperitoneal liposarcoma were analyzed retrospectively.The relationship between CT features and tumor type were compared using Fisher＇s exact test.Results CT features that only or mainly associated with exophytic renal angiomyolipoma were renal parenchymal defect at the junction between tumor and kidney,enlarged vessels,supply of renal artery branches and tumoral vessel extending through the renal parenchyma（all P〈0.01）,whereas that associated with retroperitoneal liposarcoma were anteriorly displaced kidney and non-fat-attenuating enhanced intratumoral nodules（all P〈0.01）.There was no significant difference in the presence of calcification,hemorrhage and combined with angiomyolipoma in both diseases（all P〈0.05）.Conclusion CT features can be used to differentiate exophytic renal angiomyolipoma from retroperitoneal liposarcoma effectively.