CT在诊断肾血管平滑肌脂肪瘤中的作用

Evaluation of CT in diagnosis of angiomyolipomas

目的 :评价CT扫描在诊断肾血管平滑肌脂肪瘤中的价值。材料与方法 :回顾性分析14例经手术病理证实的肾血管平滑肌脂肪瘤的CT资料。结果 :本组14例均不伴结节硬化症 ,11例为单侧发病 ,3例为双侧发病 ,其中1例合并肾包膜下血肿。肿块直径最小为1 5cm ,最大为18 9cm。CT均表现为肾区圆形或类圆形肿块 ,边界清楚 ,密度不均 ,内含软组织与脂肪密度成份 ,多以低密度脂肪成分为主 ,CT值在 -33Hu～ -90Hu左右 ,无强化表现 ,软组织部分及其中之条状分隔均有不同程度强化。结论 :CT检查可对肾血管平滑肌脂肪瘤进行定性定位诊断 ,通过薄层扫描和数字图像显示象素CT值有助于鉴别肾血管平滑肌脂肪瘤与肾癌、肾囊肿等疾病。

Objective:To evaluate CT in the diagnosis of angiomyolipomas(AMLs).Materials and Methods:14 cases of angiomyolipomas proven by pathology were analyzed retrospectively.Results:14 cases belong to the second classification of angiomyolipomas.Angiomyolipomas are benign renal neoplasms that consist of varying amounts of mature adipose tissue,smooth muscle,and thick-walled blood vessels.3 cases had bilateral AMLs.Conclusions:Accurate diagnosis of AMLs can be made in virtually all cases using CT,which is very sensitive to the low attenuation of fat.Measurement of densities on precontrast images is preferable,since the enhancement of the blood vessels coursing through the fat may increase the average density of the lesion to the water or soft tissue range.In lesions with very small amounts of fat,analysis of the individual pixel CT numbers can be diagnostic.