肾脏黏液样小管状和梭形细胞癌的CT表现

CT Manifestations of Renal Mucinous Tubular and Spindle Cell Carcinomas

目的总结肾脏黏液样小管状和梭形细胞癌（MTSCC）的CT表现,提高对其认识。方法回顾性分析6例经手术病理证实的MTSCC的CT表现。男6例,年龄为45～77岁,中位年龄52岁,均行CT平扫及三期增强。分析病灶的位置、大小,肿瘤内部密度,强化,周边侵犯及转移等表现。结果左肾4例,右肾2例,最大径在3.1～11.2 cm之间。4例病灶密度欠均匀,以等低密度为主,其中3例病灶内见点片状高密度出血,2例呈均匀低密度。6例MTSCC病灶主体均位于肾内,其中3例有包膜。平扫时肿瘤的CT均值为33.4 HU,增强后肾皮质期、髓质期和延迟期分别为44.8 HU,57.1 HU,68.0 HU。6例均表现为渐进性强化。结论 MTSCC的CT表现有一些特征性,平扫密度不均匀,常伴囊变、出血,病灶主要位于肾内且有包膜,增强后早期轻度强化、然后呈渐进性强化,这些CT表现对提高该病的诊断有一定帮助。

Objective To summarize CT manifestations of renal mucinous tubular and spindle cell carcinoma （MTSCC） in order to make a further understanding of this disease.. Methods The clinical data and CT findings of 6 pa- tients with pathologically-proved MTSCC were retrospectively analyzed. All patients were males, with a mean age of 58.2 years （45 -77 years）. Plain CT scanning and triphasic-enhanced CT scanning were carried out in all the 6 patients. The location, size, density and enhancement pattern of the tumor, the neighboring invasion and distant metastasis were ana- lyzed. Results The tumor was located at the left kidney in 5 cases and at the right kidney in one case. The maximum di- ameter of the lesions ranged from 3.1 cm to 11.2 cm. The lesions showed heterogeneous density, mainly iso- or hypo-den- sity, in 4 cases, and in three of them spot and patch high-density hemorrhage was observed within the lesions. In 2 cases the lesions showed homogeneous hypo-density. In the 6 cases, the lesions of MTSCC were mainly located in the kidneys, in three of them the lesion was capsulated. On plain CT scans, the mean CT value of the tumor was 33.4 HU. After the injec- tion of contrast the tumor showed gradual progressive enhancement pattern in all 6 cases, and its CT values at cortex phase, medulla phase and delayed phase were 44.8 HU, 57.1 HU and 68.0 HU respectively. Conclusion MTSCC has certain CT characteristics, such as inhomogeneous density with cystic degeneration and hemorrhage on plain scans, and the lesions are capsulated and located within the kidneys with early and gradual progressive enhancement, all of which are helpful in making diagnosis.