肾脏上皮样血管平滑肌脂肪瘤的CT表现

CT Findings of Renal Epithelioid Angiomyolipoma

目的探讨肾脏上皮样血管平滑肌脂肪瘤(EAML)的CT表现特点。方法回顾性分析经病理证实的8例EAML的CT影像特征。结果 8例(共10个病灶)中6例单发,2例多发;5例(7个病灶)含有明确脂肪成分;CT平扫呈圆形或类圆形的稍高密度肿块;增强扫描皮质期均有不同程度的强化;静脉期7例持续强化,1例强化程度下降。结论 EAML的CT表现有一定特征性,增强扫描有助于与肾透明细胞癌及肾盂癌相鉴别,但与经典型血管平滑肌脂肪瘤难以鉴别,确诊仍需依靠病理检查。

Objective To analyze the CT features of the renal epithelioid angiomyolipoma（EAML）. Methods Eight cases of renal epithelioid angiomyolipoma approved pathologically were collected. CT imagings were analyzed and literatures were review. Results In all cases, single lesion was found in 6 cases and multiple lesions in 2 （total of 10 lesions）. Fat density was detected in 7 lesions of 5 cases. The masses were round or oval shape. The substantial parts of all lesions showed slightly higher density than that of normal renal cortex on plan CT images , with intense enhancement in cortical phase in all 8 lesions, continuous enhancement in medullary phase in 7 and declining enhancement in medullary phase in 1 lesion. Conclusion EAML was constantly misdiagnosed before surgery. Although CT manifestations had contribute to dif- ferentiate EAML from renal cell carcinoma, it is difficult to identify EAML from renal angiomyolipoma, and confirmed diag- nosis should rely on pathological examination.