肾脏嫌色细胞癌的影像学特征分析

Analysis of the image of chromophobe renal cell carcinoma

目的探讨肾脏嫌色细胞癌(chromophobe cell renal carcinoma,CRCC)的CT、MRI影像特点,提高其影像诊断及鉴别诊断能力。方法回顾性分析9例经手术病理证实的肾脏嫌色细胞癌患者的CT、MRI表现。结果 9例肾脏嫌色细胞癌右侧5例,左侧4例。CT平扫及增强扫描9例,均为单发,类圆形肿瘤或肿块;平扫6例密度均匀,呈等或略高密度,2例有低密度囊变坏死,1例有囊变坏死钙化,2例可见假包膜;增强扫描1例皮质期明显强化,1例不均匀轻度强化,余7例呈轻至中等均匀强化,2例可见中心瘢痕明显强化;MRI平扫加增强扫描3例,平扫均为等、低信号(与肾皮质),可见完整或不完整假包膜,2例可见囊变坏死,与肾实质交界面为圆钝状;DWI上1例为晕环状略高信号,2例为均匀等、略高信号;1例明显强化,2例呈轻至中度强化,3例见中心瘢痕,2例T2WI为高信号,1例为低信号,呈点状、轮辐状持续明显强化。结论 CRCC为少血供实性肿瘤,MRI容易检出肿瘤囊变坏死、假包膜及中心星状或轮辐状瘢痕,能够对CRCC的诊断提供更多的价值。

Objective To explore the CT and MRI performance characteristics of chromophobe renal cell carcinoma, so as to improve the imaging diagnosis and differential diagnosis. Methods The CT and MRI findings of 9 cases of chromophobe cell renal carcinoma proved surgicallyl and pathlogicalyl were analyzed retrospectively. Results All of 9 cases were unilateral and solitary, 5 cases were located in the right kidney, and the other in the left kidney in 4 cases. All 9 patients underwent plain and enhanced CT scan and presented with a round mass. On unenhanced CT, 6 cases presented with of uniform density, such as equal density or slightly higher density, 2 cases with low density cystic degeneration necrosis, 1 case with cystic necrosis and calcification, and 2 csaes with pseudocapsule;on enhanced CT, 1 case was obviously enhancement in cortical phase, 1 case showed inhomogeneous mild enhancement, 7 cases showed mild to moderate homogeneous enhancement, 2 cases showed obvious enhancement in the central scar; 3 cases underwent plain and enhanced MRI scan, the tumors were iso-hypointensity on plain MRI scan with complete or incomplete pseudocapsule, 2 cases presented with cystic necrosis, the tumor and renal parenchyma interfaces with blunt shape ; one case of DWI image was halo ring slightly high signal, the other 2 cases were homogeneous and slightly high signal; 1 case showed obvious enhancement, 2 cases showed mild to moderate enhancement, 3 cases presented with central scar, there were 2 cases with high signal on T2 WI and low signal in 1 case, exhibiting enhancement of tumor in dot, spoking continuous enhancement. Conclusion CRCC is less blood supply of solid tumors. MRI is easy to detect tumor cystic degeneration necrosis, pseudocapsule and the central star shaped or spoke scar. MRI can provide more value for the diagnosis of CRCC.