肾上皮样与非上皮样血管平滑肌脂肪瘤磁共振影像表现与鉴别诊断

Magnetic resonance imaging findings and differential diagnosis of renal epithelioid angiomyolipoma comparing with renal no-epithelioid angiomyolipoma

目的探讨磁共振影像特征对鉴别肾上皮样血管平滑肌脂肪瘤(EAML)和非上皮样(经典型)血管平滑肌脂肪瘤(AML)的可能性。方法本研究采用解放军总医院2009年1月至2015年6月的资料,做回顾性对照分析,病例组为12例EAML(年龄27~61岁,平均46.7岁,男2例、女10例),对照组为32例非上皮样(经典型)AML(年龄34~70岁,平均53.4岁,男9例、女23例)。研究的MRI征象包括性别、T2WI信号、脂肪、假包膜、囊变坏死、出血、DWI信号、三期动态增强峰值实相。采用SPSS 19.0统计软件,计数资料采用X^2。检验和单向有序列联表分析。结果肾EAML与AML相比,无脂肪、有坏死囊变和出血差异有统计学意义(P值分别为0.002、0.007、0.025)。性别、实性成分T2WI信号、DWI、假包膜及增强强化峰值时相差异无统计学意义(P值分别为0.863、0.053、0.479、0.460)。结论与AML相比,在无脂肪时,有坏死囊变或出血的肿瘤对EAML的诊断有提示作用。

Objective To investigate whether MRI findings can differentiate renal epithelioid angiomyolipoma (EAML)from renal no-epithelioid (typical)angiomyolipoma.Methods A total of 44 patients were collected from General Hospital of PLA.These cases were obtained from January 2009to June 2015.To retrospectively analyze these mainly MRI findings among 12cases of EAML (age from 27to 61 years,male 2cases,female 10cases,mean age was 46.7years);32cases of renal no-epithelioid AML (age from 34to 70years old,male 9cases,female 23cases,mean age was 53.4years old)as case control study. MRI findings included gender,T2WI,the signal on gross fat,pseudocapsle,necrosis or cystic degeneration, DWI,hemorrhage and the peak in three phases of dynamic enhancement.All data were analyzed statistically using SPSS version 19.0(IBM,Armonk,NY,USA).X^2test and a single order chart were used to analyze the enumeration data.Results Comparing with renal no-epithelioid angiomyolipoma,minimal fat,necrosis or cystic degeneration and hemorrhage were statistical significance.P values were 0.002,0.007,0.025, respectively.Gender,solid components of tumors on T2WI,the signal of DWI,pesudocapsule and the peak of enhancement had no statistical significance.P values were 0.863,0.053,0.479,0.460,respectively. Conclusion Comparing with renal no-epithelioid AML,necrosis or cystic degeneration and hemorrhage with minimal fat are characteristic MRI findings of EAML.