肾血管平滑肌脂肪瘤的综合影像学诊断评价与病理

General Imaging Diagnosis Evaluation and Pathology of the Renal Angiomyolipoma

目的 结合手术病理结果,评价肾血管平滑肌脂肪瘤的影像学诊断.材料和方法 收治15例RAL患者其中11例经手术病理证实,4例由CT确诊.分析其腹平片、肾盂造影、B超、CT和病理资料,评价不同影像手段对本病诊断的价值和限度.结果 膜部平片和肾盂造影无特征性;B超典型表现为强回声光团,当肿瘤内含脂肪细胞较少或合并出血时可呈不典型的混合型或低回声型;CT发现肿块内脂肪低密度和低CT值为本病的特征.当表现为软组织密度时难与肾癌鉴别.结论 RAL的影像学表现与肿瘤的病理特点密切相关.B超和CT具有定性作用.不典型者仍须进一步检查.

Objective To evaluate the imaging diagnosis of Renal angiomyolipoma (RAL) with surgico-pathological data. Materials and methods We have analysed the imaging examinations and pathological data of 15 cases of RAL, amony them 11 cases were diagnosed by surgery and pathology, 4 were diagnosed by CT scans. The imaging examinations include the X-ray abdominal films and pyelograms, the ultrasound and CT scannings. The value and limitations of the above methods were compared and assessed. Results There were no specific findings on the X-ray abdominal films and pyclogram. High-amplitude echos were revealed in ultrasound in typical cases, while in atypical case, low - amplitude echos were revealed because of less fatty cells in the tumor and bleeding complications. The lower fatty densities (on the CT images are the characteristic of RAL, Otherwise it) is very difficult to differentiate a RAL from a renal carcinoma. Conclusions The imaging findings of RAL are closely related to the pathological feature of the tumor. The CT scans and (the ultrasoundhave the value in comfirming diagnosis.) In atypical patients, further examinations should be carried out to make the differentiations.