肾嗜酸细胞腺瘤的MSCT征象

The Study of CT Features of Renal Oncocytoma

目的:探讨和分析肾嗜酸细胞腺瘤的CT表现,进一步提高诊断准确率。方法:回顾性分析16例经病理证实的肾脏嗜酸细胞腺瘤,对其临床资料及CT征象进行分析总结。结果:16例患者中,男女比例1︰1,年龄46~77岁,中位年龄61.5岁。球形者14例,豆形者2例:最大径110.18~65 mm,平均为(37.87±3.11)mm。所有病例相对明显强化(16/16,100%),肿瘤强化指数(增强各期CT值/周围正常肾皮质,均小于1),强化幅度(增强各期的CT值-平扫CT值),强化峰值在实质期者为(12/16,75%),嗜酸细胞腺瘤出现“辐轮征”(2/16,12.5%)、星芒状瘢痕(6/16,37.5%)、“分段增强反演”现象(8/16,50%)。结论:肾嗜酸细胞皮质期呈现相对明显强化,低于正常肾皮质,峰值多在实质期,同时可能出现“分段增强反演”(直径小于40 mm)及星芒状瘢痕(直径大于30 mm),部分星芒状瘢痕延迟强化且范围有不同程度有所缩小。

Purpose:To explore and analysis the MSCT features of renal oncocytoma(RO)in order to improve its diagnosis and treatment level.Methods:Sixteen cases of RO which were confirmed by pathology results were analyzed retrospectively,and the clinical data and some CT features including the morphology and CT value of plain scanning and three phases of enhancements scanning were analyzed.Results:Among the 16 patients,there was a 1:1 male to female ratio.Patients'ages ranged from 46 to 77 years,and the median age was 61.5 years.Most tumors were ball shaped;two cases were bean shaped.The maximum diameter of tumors ranged from 18 to 65mm,and the average maximum diameter was 39.0±26.8 mm.All cases(16/16,100%)showed obvious enhancement,but the degrees of enhancement were less than the enhancement of renal cortex(average ratio of lesion-to-cortex attenuation:0.78+0.03).The average range of lesion-to-cortex attenuation showed that the peak enhancements in parenchymal phase were shown in 12 cases(12/16,75%).There were 6 cases(6/16,37.5%)with stellate scar.Eight cases(8/16,50%)showed with segmental enhancement inversion.Conclusion:RO appears enhancement in the corticomedullary phase and lower than the renal cortex,the peak enhancements is in the parenchymal phase.At the same time,segmented enhancement inversion(diameter less than 40mm)and stellate scars(diameter greater than 30mm)may occur,and the enhancement of some stellate scars are delayed and their range are always reduced.