肾脏原发性原始神经外胚层肿瘤的MSCT诊断(附4例报告)

CT diagnosis of primary primitive neuroectodermal tumors of kidney(report of 4 cases)

目的探讨肾脏原发性原始神经外胚层肿瘤(primitive neuroectodermal tumor,PNET)的MSCT特征,以提高其影像学诊断水平。方法回顾性分析4例经手术后病理证实的肾脏PNET的临床及影像学资料,4例均行CT平扫及增强检查。结果本组4例肾脏PNET中,男性2例,女性2例,年龄15~40岁,平均26.8岁。1例位于右肾,3例位于左肾;1例呈类圆形,3例呈不规则形;瘤体直径约3.8~12.0cm;3例边缘不清晰,1例清晰。CT平扫肾肿瘤呈均匀或不均匀等、低密度影,CT增强扫描皮质期瘤体实性部分呈斑片状、絮状及索条状轻~中度强化,实质期瘤体呈持续性强化,囊性成分及坏死区无强化;3例合并下腔静脉或肾静脉瘤栓。结论肾脏原发性PNET临床罕见,MSCT检查对本病的诊断有一定作用,但确诊仍需行病理检查。

Objective To investigate the MSCT characteristics of primary primitive neuroectodermal tumor(PNET)in the kidneys in order to improve the imaging diagnostic level.Methods The clinical and imaging data collected from 4 cases of renal PNET confirmed by postoperative pathology were analyzed retrospectively.CT plain scan and contrast-enhanced examination were performed in all the cases.Results There were four cases of renal PNET in this group,including 2 cases of male,2 cases of females,aged 15~40 years old,averaged at 26.8 years old;1 case was located in the right kidney and 3 cases were located in the left kidney;1 case was shown in the shape of round,and 3 cases were irregular shape;the diameters of tumor ranged from 3.8 cm to 12.0 cm;The edges of 3 cases were unclear and that of 1 case was clear.CT scan showed uniform or uneven density or low density shadow,enhanced scanning showed solid portion of the mass exhibiting speckled strip moderate enhancement during arterial phase,substance phase showed continuous enhancement,cystic components and necrosis area did not strengthen;3 cases were combined with inferior vena cava or renal vein thrombosis.Conclusion The primary PNET of kidney is rare,and MSCT examination has a certain effect on the diagnosis of the disease,but it still needs to be diagnosed by pathology.