肾细胞癌的MRI影像分析

MRI Analysis of Renal Cell Carcinoma

目的分析肾细胞癌MRI信号特点,提高对肾细胞癌的诊断水平.方法收集有完整临床资料及病理证实肾癌46例,均做T1WI、T2WI、TRUFI序列检查,同时加做增强扫描,其中10例做MRI动态增强扫描.结果透明细胞型39例,嫌色细胞型5例,乳头状细胞型2例.T1WI均匀等或低信号35例,混杂信号11例;T2WI均匀高信号17例,等信号5例,混杂信号24例.显示假包膜者10例.肾窦侵犯13例,肾周侵犯14例,肾静脉癌栓2例,腹膜后或肾门淋巴结肿大13例,肝脏转移2例.增强后,7例病灶均匀强化,32例不均匀强化,4例强化环内壁不规则,3例均匀环状强化(假包膜强化).结论仔细分析病灶的信号特点,MRI能够准确诊断肾癌,且能了解肿瘤向周边侵犯及远处转移情况,尤其对小肾癌诊断,MRI价值独特.

Objective To analyse MRI manifestations of renal cell carcinoma,and to improve the diagnosis of renal cell carcinoma.Methods 46 cases of renal cell carcinoma proved by surgery and pathology were examined with MRI scan（includingT1WI,T2WI and TRUFI）and received enhallced scan at the same time before operation,10 cases in which received dynamic contrast-enhanced MRI scan.Results Of the 46 cases,there were clear cell carcinoma in 39,Chromophobe cell carcinoma in 5 and papillary cell carcinoma in 2.The tumors were homogeneous Equivalent or low signal intensity in 35 and isointensity in 11 on T1WI;while,slight high signal intensity in 17,equivalent signal intensity in 5 and isointensity in 24 onT2WI.Pseudocapsule was found in 10.Renal sinus and surrounding of kidney were invaded in 13 and 14 respectively.Renal vein was embolized by carcinoma in 2.Metastasis of lymph nodes of retroperitoneum or rebak hilum was in 13,and metastasis of liver was in 2.After enhanced scan,homogeneous enhancementwas presented in 7,inhomogeneous enhancement in 32,inhomogeneous circular enhancement in 4 and homogeneous circular enhancement in 3.Conclusion By careful analysis of signal intensity of tumors,the evidence of renal cell carcinoma,surroundings involved by tumors and distant metastasis can be detected precisely by MRI.