肾血管平滑肌脂肪瘤的多层螺旋CT诊断

Multi-slice CT Diagnosis of Renal Angiomyolipoma

目的:探讨多层螺旋CT在肾血管平滑肌脂肪瘤诊断中的价值。方法:14例肾血管平滑肌脂肪瘤患者行多层螺旋CT扫描检查,并在工作站行MPR、MIP图像重建,分析肾血管平滑肌脂肪瘤的MSCT表现,并与手术病理结果对照。结果:14例肾血管平滑肌脂肪瘤CT平扫肿块均呈等、低、高低混杂密度,11例其中显示有脂肪密度,1例显示高密度出血灶。多期增强扫描皮质期肿块呈均匀或不均匀强化,但低于肾皮髓质强化,脂肪、坏死囊变、出血区无强化,分泌期肿块持续强化。MIP显示肿块内纡曲、增粗的血管。结论:多层螺旋CT能显示肾血管平滑肌脂肪瘤肿块内的脂肪成分及血管成分,多期增强扫描能了解肿块的强化方式,对肾血管平滑肌脂肪瘤的诊断具有重要价值。

Objective： To investigate the value of multi-slice CT in the diagnosis of the renal angiomyolipoma. Methods： 14 cases with renal angiomyolipoma underwent preoperative contrast-enhanced multi-slice CT （MSCT）. The raw data were transferred to the workstation and then processed with multiplanar reconstruction （MPR） and maximum intensity projection （MIP）. The MSCT manifestations of the renal angiomyolipoma were analysed and correlated with surgical and pathological findings. Results：14 cases of angiomyolipoma on plain scan were isodense, slightly hypodense,or hyper-hypo mixed dense. Fat components were displayed in 11 cases,hemorrhage in one case. After contrast scan, the lesions were homogeneous or heterogeneous enhanced at arterial phase but the enhancement was lower than the renal cortex, prolonged enhancement was seen at venous phase. Tortuous and enlarged vessels were found in the lesion on MIP. Conlusion：Multi-slice CT can display the fat and vascular constituents of the renal angiomyolipoma and the enhanced model can be shown on multi-phase enhancement,thus MSCT is a valuable technique for the diagnosis of the renal angiomyolipoma.