肾嗜酸细胞腺瘤的影像学表现及鉴别诊断

The radiographic findings and differential diagnosis of the renal oncocytoma

目的:探讨肾嗜酸性细胞腺瘤的CT和MRI表现,以提高对本病的认识。方法:回顾性分析经病理证实的9例肾嗜酸细胞腺瘤患者的影像资料。9例均行CT平扫及多期增强扫描,包括肾皮质期、髓质期和排泄期;其中1例同时行MRI检查,1例行IVP检查。结果:CT平扫示9例病灶均为单发;7例位于左肾,2例位于右肾,最大径2.0～10.0cm,平均5.1cm,<3.0cm者2例,2例可见钙化。增强扫描:肾皮质期示9例病灶明显强化,肾髓质期示6例病灶持续强化,6例病灶内可见"星芒"状瘢痕,5例有相对完整假包膜。1例病灶于MRIT1WI上呈等、低信号,T2WI呈混杂高信号,可见清晰包膜。结论:肾嗜酸细胞腺瘤的影像学表现有一定特征性,有助于同肾癌和肾血管平滑肌脂肪瘤鉴别。

Objective： To discuss the imaging features of renal oncecytoma, and to make a further understanding of the disease. Methods：The imaging features of 9 pathology proved oncecytomas were reviewed retrospectively. All patients underwent pre-contrast and multi- ple phase contrast scanning on multi-slice CT. One patient hod MR examination. One patient hod IVP examination. Results：On CT pre- contrast images, all patients hod solitary lesion, the location of oncocytoma were in left kidney （n = 7） and right kidney （n = 2）. The maximum dimension of lesion ranged from 2.0 - 10.0 cm （average 5.1 cm）. Two lesions were less than 3.0 cm. Six lesions showed obvious enhancement on the cortieo-medullary phase; On the parenchymal phase, six lesions showed continuous enhancement. Central stellate scar was found in six lesions and psudocapsule was observed in five, ealeifteation was observed in two lesions, one lesion underwent MR examination, which showed iso-/hypo-intensity on T1WI and hyperiniensity on T2WI. Clear psudoeapsule on T2WI was revealed in MR imaging. Conclusion：Most of the oncocytomas showed certain characteristics, which are helpful in the differential diagnosis with renal ceil carcinoma and renal angioinyolipoma.