肾脏嫌色细胞癌及嗜酸性腺瘤的MSCT表现分析

Imaging features of chromophobe cell renal carcinoma and renal oncocytoma on MSCT

目的:分析肾脏嫌色细胞(CCRC)及嗜酸性腺瘤(RO)的MSCT表现,提升诊断水平。方法:回顾性分析19例经手术病理证实的CCRC和RO的CT影像资料,分析MSCT的特征。结果:13例CCRC位于左肾8例,右肾5例,病灶直径约(5.4±1.8)cm,形态呈圆形或类圆形9例,分叶状3例,边界清晰者8例(6例有假包膜),1例累及肾盂,1例累及肾周筋膜,1例累及肝包膜。6例RO位于左肾1例,右肾5例,病灶直径约(7.2±2.6)cm,形态呈圆形或类圆形3例,分叶状3例,边界清晰者4例(2例有假包膜)。13例CCRC平扫呈等或低密度(CT值39.4±8.90HU),具有杯口征6例,中央瘢痕2例,瘤内血管征9例,瘤周静脉征5例。轻度强化4例,中度强化4例,重度强化5例。均质强化4例,不均质强化8例,轮辐状强化1例。6例RO平扫呈等或稍高密度(CT值40±14.47HU),密度均匀,杯口征1例,中央瘢痕2例,瘤内血管征2例,瘤周静脉征2例。轻度强化1例,重度强化5例。均质强化4例,不均质强化1例,节段增强反转1例。结论:肾脏CCRC及RO的MSCT征像有一定特征性,结合动态增强分析,有助于诊断及鉴别诊断。

Objective Analysis of MSCT findings of renal chromophobe(CCRC) and eosinophilic adenoma(RO) to improve diagnostic level.Methods The CT images of 19 cases of CCRC and RO confirmed by operation and pathology were retrospectively analyzed to analyze the characteristics of MSCT. Results 13 cases of CCRC were located in 8 cases of left kidney and 5 cases of right kidney. The diameter of lesion was about(5.4±1.8) cm. Conclusion Combined imaging findings of CT dynamic enhanced mode can provide characteristic information for diagnosis of CCRC,and comprehensive analysis of the imaging findings will contribute to the diagnosis and differential diagnosis. There were 9 cases with round or round shape, 3 cases with lobulated shape, 8 cases with clear boundary(6 cases with pseudo-envelope), 1 case with renal pelvis, 1 case with perirenal fascia, and 1 case with hepatic capsule. 6 cases of RO were located in 1 case of left kidney and 5 cases of right kidney.The diameter of lesion was about(7.2±2.6) cm. The shape was round or round in 3 cases, lobulated in 3 cases, and borders were clear in 4 cases(2 cases with pseudo-envelope). 13 cases of CCRC were equally or low-density(CT value 39.4±8.90 HU),with 6 cases of cup mouth sign, 2 cases of central scar, 9 cases of intratumoral vascular sign, and 5 cases of peritumoral venous sign. There were 4 cases of mild enhancement, 4 cases of moderate enhancement, and 5 cases of severe enhancement. There were 4 cases of homogenization enhancement, 8 cases of heterogeneity enhancement, and 1 case of spoke-like enhancement.6 cases of RO were equally or slightly high density(CT value 40±14.47 HU), uniform density, 1 case of cup mouth sign, 2 cases of central scar, 2 cases of intratumoral vascular sign, and 2 cases of peritumoral venous sign. 1 case was mildly enhanced and 5 cases were severely strengthened. There were 4 cases of homogenization enhancement, 1 case of heterogeneity enhancement,and 1 case of segmental enhancement. Conclusion The MSCT signs of renal CCRC and RO have certain characteristics,combined with dynamic enhancement analysis, which is helpful for diagnosis and differential diagnosis.