乳头状肾细胞癌的MR影像表现与病理对照分析

MR Imaging Features of Papillary Renal Cell Carcinoma with Pathological Correlation

目的:探讨磁共振成像对乳头状肾细胞癌(Papillary Renal Cell Carcinoma,PRCC)的诊断价值。材料和方法:回顾性分析10例经病理证实的10例乳头状肾细胞癌的MR影像表现,观察病灶的形态特征,信号强度并与病理形态学表现进行对照。结果:10例乳头状肾细胞癌在T2加权图像上均表现为低信号,术后病理9例病灶间质内见含铁血黄素沉积;显微镜下9例病灶仅在乳头状结构中存在纤细的血管,这9例增强后表现为持续轻度强化。术后4例所见囊性变与MRI上囊变信号灶基本一致。结论:乳头状肾细胞癌T2WI低信号的特征及乏血供的增强模式能够较准确反映其病理特点,对该肾细胞癌亚型的诊断具有一定的特异性,有助于该病的诊断及鉴别诊断。

Purpose： To evaluate MR imaging features of papillary renal cell carcinoma （PRCC）. Materials and Methods： 10 cases of PRCC confirmed by histopathology were retrospectively analyzed. MRI morphological characteristics and signal intensity of the lesions were observed and compared with findings of pathomorphology. Results： 10 cases of PRCC displayed relatively homogeneous hypointensity on T2WI, 9 of which showed hemosiderin granules in macrophages and stroma. Microscopically tumor papillae contain a delicate fibrovaseular core in 9 cases, and on dynamic-enhanced images, these nine cases showed mild enhancement. Pathological cystic degeneration was detected in 4 cases which corresponded to the cystic lesions on MRI. Conclusions： Hypointensity on T2WI and mild enhancement pattern due to poor blood supply are the imaging characteristics of PRCC. The MR findings can reflect the pathologic features of the tumor, which may facilitate the diagnosis and differential diagnosis.