多房囊性肾瘤的影像学表现

The image features of multilocular cystic nephroma

目的 探讨多房囊性肾瘤的影像学特征及相关的多房囊性病变的鉴别诊断。方法回顾性分析8例经手术病理证实的多房囊性肾瘤的CT和MRI资料。结果 8例多房囊性肾瘤均为单侧,直径从2.5-7.5 cm不等。CT或MR扫描显示有完整囊壁,内由多个小囊腔和分隔构成,其中2例囊内分隔显示清晰,4例显示尚清晰,另2例显示不清,边缘模糊。所有囊腔间无交通,囊壁和囊内分隔有不同程度的强化,但均未见实质性结节。4例MR扫描在T1WI上呈低信号,T2WI为高信号,延迟增强扫描囊壁和囊内分隔显示较同步的CT扫描清晰。组织病理学显示所有病例的包膜和分隔内衬扁平或立方上皮。结论 多房囊性肾瘤是肾脏的少见病变,CT和MRI能准确地显示病灶的形态学特征,并提供相应的诊断依据,但在和多房囊性肾癌等病变鉴别时仍有一定的难度。

Objective To explore the image features of multilocular cystic nephroma and its correlative differential diagnosis. Methods Eight cases of multilocular cystic nephroma were retrospectively analyzed by comparing the imaging findings with surgical and pathological results. Results In all 8 cases, multilocular cystic nephromas were unilateral and circumscribed by thick capsules. These lesions ranged in diameter from 2. 5 cm to 7. 5 cm. The lesions were entirely composed of locules and septa without solid nodules. These locules did not communicate with each other. The septa of these lesions were clear in 2 cases, partly clear in 4 cases, and not very clear in 2 cases. All lesions were better detected on enhanced scans than on non-enhanced ones. Four of 8 cases also underwent MR scan, which presented low signal intensity on T1WI and high signal intensity on T2WI. The Interlocular septa was demonstrated much better with MM than with CT. Histopathology proved that the capsule and septa of the lesions were lined by cuboidal or flattened epithelial cells. Conclusion Multilocular cystic nephroma is a rare disease of the kidney. CT and MRI scanning are valuable in the diagnosis of multilocular cystic nephroma, but the imaging features are not specific enough to differentiate benign multilocular cystic nephroma from multilocular cystic renal cell carcinoma.