乏脂肪性肾血管平滑肌脂肪瘤的CT表现

CT findings of renal angiomyolipoma with minimal fat

目的探讨乏脂肪肾血管平滑肌脂肪瘤(RAML)的CT表现,以提高其诊断准确性。方法 14例RAML患者均经腹部CT平扫和动态增强扫描,对所有患者RAML病灶的数目、形态、密度、是否合并钙化以及强化型式进行回顾性分析,全部病例经手术和病理学确诊。结果多数病灶为边界清楚的圆形肿物,单发或多发,CT平扫多呈等或高密度影,本组病例未见瘤内钙化灶。所有患者的RAML病灶在动态增强的皮质期与实质期均表现为均匀的持续性强化。结论乏脂肪RAML病灶多表现为边界清楚的实性肿块,少有钙化。CT观察病灶的形态,密度及强化形式等特征性表现,有助于提高其定性诊断的准确性。

Objective To study the CT findings of renal angiomyolipoma（RAML） with minimal fat so as to improve the diagnostic accuracy.Methods Fourteen patients with RAML with minimal fat underwent plain and postcontrast CT scans of the abdomen.The CT findings of the number,shape,density,intralesional calcification and enhanced pattern of RAML were retrospectively analyzed.All cases were confirmed by surgery and pathology.Results The plain CT scanning showed that sharply demarcated round solid masses majority cases,single or multiple,with homogeneous density or somehow higher.No intralesional calcification was found in any case.The RAML lesions appeared as homogeneous and continuous enhancement during dynamic-enhanced cortex phase and parenchyrnal phase in all patients.Conclusion Most RAML with minimal fat are sharply demarcated round solid masses without intralesional calcification.The specific findings of CT images such as shape,density and enhanced pattern are very helpful to improve the accuracy of qualitative diagnosis.