肾脏嗜酸细胞腺瘤的CT诊断

CT Diagnosis of Renal Oncocytoma

目的探讨肾嗜酸细胞腺瘤（RO）的CT表现，以提高对其诊断的准确性。资料与方法回顾性分析经病理证实的14例RO的CT资料，全部经MSCT多期检查，包括平扫、增强皮质期和髓质期，其中5例另行排泄期扫描。结果病灶全部单发，9例位于左肾，5例位于右肾，最大径2．0—11．6cm，平均6．2cm，〈3．0cm者3例。皮质期，12例病灶明显强化，其中9例强化低于肾皮质，3例强化接近于肾皮质。髓质期，9例强化程度下降并低于肾脏髓质，3例持续强化但在排泄期见密度开始下降。2例在皮质期至排泄期表现为持续的强化。8例见星芒样瘢痕，8例见完整包膜，4例见中央钙化。结论大部分RO为富血供，增强后实质部分均匀强化，囊变或坏死罕见，有助于与肾透明细胞癌及肾嫌色细胞癌等相鉴别。

Objective To evaluate CT findings of renal oncocytoma （RO）. Materials and methods CT findings in 14 patients with RO confirmed by pathology were reviewed retrospectively. All patients underwent pre-contrast scanning and multiple phase contrast scanning on multi-slice CT （MSCT）. Results All patients showed a solitary mass, in which the mass was found in left kidney in nine cases and in right kidney in 5 cases. Marked enhancement of the mass was revealed on cortical phase in 12 patients, in which the degree of enhancement decreased and the density was lower than that of the renal medulla on the medullary phase in nine cases, and enhancement remained on the excretory phase. Central stellate scar was identified in eight patients, complete capsule in eight lesions, and calcification in four cases. Conclusions Most ROs were richly vascular tumors with homogeneous enhancement of the mass and rare cystic degeneration of necrosis, which could be useful in differentiating between RO and the renal carcinoma.