肾错构瘤声像图特征与病理学基础关系的研究

Relation of the Feature of Acoustic Image of Renal Hamartoma and Its Pathology

目的 探讨肾血管平滑肌脂肪瘤 (简称错构瘤 )声像图特点与病理学基础的关系。方法 对 2 8例肾错构瘤进行彩色多普勒超声检查 ,观察不同回声强度错构瘤的病理类型 ,肿瘤内的血流分布情况。结果 肾错构瘤的回声类型分为高回声、高低相间回声、低回声、混合性回声。肿瘤位于肾上极 8例 ,下极 14例 ,肾中部 6例 ,向肾外生长 7例 ,肿瘤大于 10cm的 15例。彩色多普勒检查 ,肾错构瘤内的血流供应分 4种类型 :①穿透型 ;②中心型 ;③边缘型 ;④混合型。病理结果 :高回声肾错构瘤为变性成熟的脂肪组织 ,低回声肾错构瘤为异型性的平滑肌和畸形的血管组织 ,高低相间回声肾错构瘤为同时含有脂肪、血管和平滑肌组织 ,混合性回声肾错构瘤为肿瘤内出血的表现。结论 超声显像从图像回声强度可较准确地估计肾错构瘤所含脂肪、平滑肌和血管的比例 ,结合彩色多普勒血流显示的情况 ,为错构瘤的诊断与鉴别诊断提供了可靠的依据。

Objective To probe into the relation of the feature of acoustic image of renal hamartoma and its pathology. Methods Twenty eight cases of renal hamartoma were checked by color Doppler ultrasound,comparing their echo intensity,blood distribution with the pathologic types. Results The echo types of renal hamartoma included high echoes,high and faint echoes,faint echoes and mixed echoes. Eight lied in the superior part of kindey,14 in the inferior part,6 in the center,7 bumped to the kindey. Diameters of 15 cases were larger than 10cm. According to the blood distribution checked by color Doppler,renal hamartoma included 4 types: ①penetrating type; ②central type; ③peripheral type; ④mixed type. Pathologic results showed: high echoes meant the degenerated adipose tissue,faint echoes heterotypic smooth muscle and deformed blood vessel,high and faint echoes were composed of all of them,mixed echoes meant tumor bleeding. Conclusion It could be determined by echo intensity that the proportion of adipose tissue and smooth muscle as well as blood vessel of the tumor. Great help to diagnose and differentiate renal hamartoma can be made by analysing the blood distribution of color Doppler at the same time.