肾脏嫌色细胞癌的CT和MRI影像特点研究

目的探讨肾脏嫌色细胞癌的cT和MPJ表现，提高对该疾病的影像学表现认识。方法回顾性分析经手术病理证实的16例嫌色细胞肾癌的cT和MRJ影像学资料，分析病灶的cT扫描表现、M刚信号特征及动态增强表现。结果10例行cT检查，表现：椭圆形或不规则软组织肿块，50％病灶可见多囊状或不规则裂隙状坏死，病灶在皮髓期均有明显强化，但其密度明显低于肾脏皮质，而与肾脏髓质接近，cT值52～81Hu，平均（64土11）Hu；实质期强化变化不大，低于肾实质，cT值53～74Hu，平均（654-7）Hu，边界显示更加清晰。分泌期GT值43～79Hu，平均（61±12）Hu，较前略有下降，呈“快进慢出”表现。8例行MR检查，表现：T1等信号，信号均匀，T2稍低信号，内可见小囊状高信号灶；对出血、坏死囊变及假包膜显示较cT清楚，强化方式与cT相仿，延迟期可见强化趋于均质化。结论肾脏嫌色细胞癌cT增强表现具有特征性，MR可以提供更多信息，对肾脏嫌色细胞癌的诊断提供更多有价值的信息。

Objective To study the CT and MRI findings of chromophobe cell renal carcinoma. Methods CT and / or MR images of sixteen cases of surgical and pathological proven chromophobe cell renal carcinoma Were reviewed and analyzed. Results Ten cases were performed CT scans. Half the cases showed homogeneous and the others showed heterogeneous in pre-contrast CT scans including cystic or slit-shaped necrosis. All cases were hyperintense in cortical phase ,which were hypointense compared with renal cortex and isointense compared with renal medulla, with CT values from 52 Hu to 81 Hu, means （64＋11）Hu; all of them were hypointense compared with the kidney in parenchyma phase, with CT values from 53 Hu to 74 Hu, means （65~7）Hu, which had a better outline; in secretory phase with CT values from 43 Hu to 79 Hu, means 61：~12 Hu. All of them were visualized as medium enhancement and presented ＂flow-in and slow-out＂ pattern. Eight cases were performed MRI scans. All cases were isointense or hypointense signal compared with renal cortex on T ]W I and hyperintense on T 2WI. MR gave a better view of hemorrhage, necrosis, cystis loci, and pseudo-capsule. MR presented the same enhancement pattern with CT, but presented isotropic enhancement in the late phase. Conclusion CT shows characteristic enhancement pattern while MRI can provide more useful information in detecting chromophobe cell renal carcinoma.