肾炎性假瘤的CT诊断及误诊分析

CT Findings of Renal In lammatory Pseudotumor

目的探讨肾炎性假瘤(IPT)的CT表现特点,分析CT诊断IPT的价值。资料与方法回顾性分析13例经手术病理证实的肾炎性假瘤患者的CT资料及相关临床资料。结果病变位于右肾5例,左肾8例,6例CT征象典型,3例不除外肾癌,4例误诊为肾癌。CT平扫示肾内单发圆形或类圆形病灶,2例为等密度,11例为等低密度,边界模糊,CT增强扫描边缘不均匀显著增强,中心存在无强化区域。结论 IPT典型者CT诊断较容易,而对于不典型的容易误诊为恶性肿瘤;肾实质内边缘强化与肾实质类似的等低密度肿块并肾周结构炎症反应具有一定特征性,CT检查结合临床表现有助于诊断IPT。

Purpose To analyze the CT features of renal inflammatory pseudotumor（IPT）.Materials and Methods CT findings and clinic data of 13 cases of IPT proved by pathology were analyzed retrospectively.Results 5 lesions located in the right kidney and 8 in the left kidney.Typical CT findings were found in 6 cases.Three patients were diagnosed suspected renal cancer.Four cases were diagnosed as renal cell carcinoma.The CT features of IPT were single,round or ovary-shaped.Two of the lesions were iso-density to the parenchyma and 11 were low density with ill-defined margin.On contrast scan,all showed inhomogenous enhancement and the margin portion of mass enhanced obviously with nonenhanced centre within the lesions.Conclusion Typical IPT can be readily diagnosed on CT.However,a typical IPT might be misdiagnosed as malignant neoplasm on CT,but some CT specific imaging features still exist,CT examination combined with clinical manifestions is helpful for the diagnosis of IPT.